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March 5, 1982

Mycobacterium marinum Infection: A Fishy Story

Author Affiliations

From the Rheumatology Section, Department of Medicine, Medical College of Georgia, Augusta. Dr Stevens is now with the Department of Radiology, University of Michigan Hospital, Ann Arbor. Dr Bell is now in private practice in Kingsport, Tenn.

JAMA. 1982;247(9):1314. doi:10.1001/jama.1982.03320340068039

INFECTION of articular and paraarticular tissue by Mycobacterium marinum is reported infrequently. In a recent review of atypical mycobacterial joint infections,1 only one was diagnosed and treated without surgery. Even in that case, drug therapy (aminosalicylic acid, isoniazid, and streptomycin sulfate) was considered "empirical" and probably not related to healing.2 In our case, the diagnosis was made without surgical biopsy, and excellent response was obtained through drug therapy alone.

Report of a Case  A 55-year-old man, previously in good health, sustained a puncture wound over the palmar surface of the second digit of the right hand at the site of the metacarpophalangeal (MCP) joint from a fish fin (red snapper, saltwater fish, nonfrozen). The wound occurred during his work in a meat market and subsequently healed. One week after injury, swelling, erythema, and increased temperature developed on the dorsal surface of the second right MCP joint. Within another