Fish tank exposure and cutaneous infections due to Mycobacterium marinum: tuberculin skin testing, treatment, and prevention

Clin Infect Dis. 2003 Aug 1;37(3):390-7. doi: 10.1086/376628. Epub 2003 Jul 18.


In the present study, 8 patients with soft tissue infection due to Mycobacterium marinum are described, and contemporary data on treatment are reviewed. Six patients had positive cultures, all patients had cutaneous exposure to fish tanks, 7 had sporotrichoid lesions, and 2 had deep infection. All 7 tested patients had tuberculin skin test reactions > or =10 mm. Six patients with disease limited to the skin were successfully treated with 2-drug combination therapy, including clarithromycin, ethambutol, and rifampin. Optimal treatment should include 2 drugs for 1-2 months after resolution of lesions, typically 3-4 months in total. Deeper infections may require more prolonged treatment and surgical debridement. Positive tuberculin reactions may be due to infection with M. marinum. Persons with open skin lesions or immunosuppression should avoid cutaneous contact with fish tanks.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Animals
  • Anti-Bacterial Agents*
  • Drug Therapy, Combination / therapeutic use*
  • Female
  • Fishes
  • Humans
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / drug therapy*
  • Mycobacterium Infections, Nontuberculous / physiopathology
  • Mycobacterium marinum / drug effects
  • Skin Diseases, Bacterial / drug therapy
  • Skin Diseases, Bacterial / physiopathology
  • Treatment Outcome
  • Tuberculin Test
  • Tuberculosis, Cutaneous / drug therapy*
  • Tuberculosis, Cutaneous / physiopathology
  • Water Microbiology


  • Anti-Bacterial Agents