Cutaneous leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Khorasan-e-Razavi, Iran.
Department of Parasitology and Mycology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Khorasan-e-Razavi, Iran.
PLoS One. 2019 Sep 19;14(9):e0221367. doi: 10.1371/journal.pone.0221367. eCollection 2019.
Mycobacterium marinum causes a rare cutaneous disease known as fish tank granuloma (FTG). The disease manifestations resemble those associated with Cutaneous Leishmaniasis (CL). The aim of this study was to determine whether FTG was the cause of cutaneous lesions in patients who were referred to the Parasitology laboratory of Imam Reza Hospital in Mashhad to be investigated for CL.
MATERIALS/METHODS: One hundered patients, clinically diagnosed with CL between April 2014 and March 2015, were included in this study. Ziehl-Neelsen staining was performed to identify acid-fast Mycobacterium in addition to bacterial cultures using Löwenstein-Jensen medium. Skin lesion samples were also collected and kept on DNA banking cards for PCR testing.
Twenty-nine of the 100 individuals with skin lesions, and therefore suspected of suffering from CL, tested positive for Mycobacterium marinum by PCR. Of these, 21 (72.4%) were male and 8(27.6%) were female. In 97% of these cases the lesions were located on hands and fingers. These patients had a history of manipulating fish and had been in contact with aquarium water. A sporotrichoid appearance was observed in 58.6% of the patients with mycobacterial lesions; 67% of patients had multiple head appearance.
Patients suspected to have CL and who test negative for CL could be affected by FTG. Therefore, after obtaining an accurate case history, molecular diagnosis is recommended for cases that give a negative result by conventional methods.
海分枝杆菌引起一种罕见的皮肤疾病，称为鱼缸肉芽肿（FTG）。该病的临床表现与皮肤利什曼病（CL）相似。本研究旨在确定 FTG 是否是 2014 年 4 月至 2015 年 3 月期间因疑似 CL 而被转诊到马什哈德伊玛目礼萨医院寄生虫学实验室的患者的皮肤损伤的原因。
材料/方法：本研究纳入了 100 名临床上被诊断为 CL 的患者。除了使用 Löwenstein-Jensen 培养基进行细菌培养外，还进行了 Ziehl-Neelsen 染色以鉴定抗酸分枝杆菌。还收集了皮肤损伤样本并保存在 DNA 银行卡上，以备 PCR 检测。
29 名有皮肤损伤的个体（因此疑似患有 CL）通过 PCR 检测出海分枝杆菌呈阳性。其中 21 名（72.4%）为男性，8 名（27.6%）为女性。在这些病例中，97%的病变位于手部和手指。这些患者有操作鱼类和接触水族馆水的病史。58.6%的分枝杆菌病变患者观察到孢子丝菌样外观；67%的患者有多个头外观。
疑似患有 CL 且 CL 检测结果为阴性的患者可能患有 FTG。因此，在获得准确的病史后，对于常规方法检测结果为阴性的病例，建议进行分子诊断。
