Mycobacterium marinum infection of the hand involving deep structures

Five patients with Mycobacterium marinum infection of the hand involving deep structures were seen recently. Four of them were fishermen. Hydrocortisone injection or simple incision and drainage led to worsening of the infection. The clinical presentation, operative finding, and histopathologic and microbiologic features were quite similar in all five patients. Extensive debridement and therapy with ethambutol and rifampin led to satisfactory results in four patients while biopsy and therapy in the fifth patient seemed to offer another form of acceptable treatment.