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To the Editor.—
We recently saw a 41-year-old man with a sporotrichoid Mycobacterium marinum (balnei) infection of the right hand and arm. The initial inoculation occurred on the right third dorsal finger and was temporally related to an abrasion sustained when the patient was cleansing his aquarium. Seven festering granulomas in the lymphatic distribution of the right arm soon developed. A biopsy specimen revealed a noncaseating tuberculoid granuloma. Treatment with potassium iodide administered orally, combination isoniazid and ethambutol administered orally, locally applied heat, intralesionally given steroids, and liquid nitrogen cryotherapy was unsuccessful, corresponding to the results of Adams et al (JAMA 211:457, 1970).Because of the well-recognized use of steroids in conjunction with antituberculous agents in the treatment of pulmonary tuberculosis, we placed the patient on isoniazid, 300 mg daily, ethambutol 1,000 mg daily, and triamcinolone, 16 mg three times daily. Dramatic resolution of the lesions began within one week
Fisher DA, Lyss RS. Mycobacterium marinum Infection. Arch Dermatol. 1974;109(4):571. doi:10.1001/archderm.1974.01630040075023
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