ABSTRACT
BACKGROUND: Mycobacterium marinum infections have been reported for over 50 years, mostly in association with trauma in the setting of water exposure. OBJECTIVE: The differential diagnosis for nodules in a sporotrichoid distribution with simultaneous bursitis is discussed. Mycobacterium marinum treatment regimens for skin and joint involvement are reviewed. METHODS: Mycobacterium marinum was identified by skin tissue culture with Lowenstein-Jensen medium at 32 degrees C. Histopathologic findings support mycobacterial infection. RESULTS: Bursitis and nodules resolved in the first 2 months of a 6-month course of minocycline treatment. CONCLUSION: Bursitis is an extremely rare but significant complication of M. marinum.
Subject(s)
Bursitis/microbiology , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium marinum , Skin Diseases, Bacterial/diagnosis , Aged , Anti-Bacterial Agents/therapeutic use , Bursitis/complications , Bursitis/drug therapy , Diagnosis, Differential , Follow-Up Studies , Humans , Male , Minocycline/therapeutic use , Mycobacterium Infections, Nontuberculous/complications , Mycobacterium Infections, Nontuberculous/drug therapy , Mycobacterium marinum/growth & development , Skin Diseases, Bacterial/complications , Skin Diseases, Bacterial/drug therapy , Sporotrichosis/diagnosisABSTRACT
On the first day of life, a healthy infant was given a recombinant hepatitis B vaccine. Over the following year, a 3 by 4.5 cm, well-defined, erythematous patch with an overlying white, reticulated, smaller plaque gradually appeared on her thigh at the vaccination site. Darier's sign was elicited at the site. Examination of a biopsy specimen showed an upper dermal mast cell infiltrate. This is the first reported case of a solitary mastocytoma appearing in a vaccination site.