Masquerading Mycobacterium: Plastic surgeon to the rescue

Area of Science:

• Dermatology
• Infectious Diseases
• Microbiology

Background:

• Mycobacterium marinum infections, often acquired from aquatic environments, present diagnostic challenges.
• These infections can mimic more common dermatological conditions, delaying appropriate treatment.

Observation:

• A case of Mycobacterium marinum infection affecting the hand is presented.
• The patient's infection mimicked eczema, fungal, and parasitic infestations, highlighting diagnostic difficulties.

Findings:

• Key diagnostic elements include a high index of suspicion, detailed exposure history (aquatic activities), tissue biopsy, and wound culture.
• Prompt empirical antibiotic therapy is essential, with treatment potentially lasting up to 24 months based on in vitro sensitivities.
• Surgical intervention (drainage and debridement) is vital for subcutaneous infections to prevent complications.

Implications:

• Raising awareness among at-risk individuals (aquarium hobbyists, fishermen) is critical for early detection.
• Prompt and appropriate management of Mycobacterium marinum infections can prevent severe outcomes like stiffness, deformity, and loss of hand function.