Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
Rev Inst Med Trop Sao Paulo. 2020 Nov 27;62:e95. doi: 10.1590/S1678-9946202062095. eCollection 2020.
Skins infections caused by Mycobacterium marinum occur only rarely. We report one case of chronic and extensive M. marinum cutaneous infection simulating chromoblastomycosis and review the pertinent literature. A 52-year-old farmer reported a 32-year chronic skin problem on his right lower limb, resulting from contact with cacti. It consisted of skin lesion presenting with dyschromic atrophic center plate and verrucous borders with hematic crusts, extending from the knee anteriorly to the inferior third of the right leg. Mycobacterium marinum infection was detected by histopathological examination of a skin fragment, culture for mycobacteria and genetic mapping of the culture material. The patient was successfully treated with Ethambutol, Rifampicin and Trimethoprim-Sulfamethoxazole. The clinical and histopathological findings of M. marinum infection is nonspecific showing clinical polymorphism and bacilli are rarely evident on histopathological examination. Given these difficulties, it is essential to perform tissue culture in a suspicious case and it is important keep this infection in mind in patients with long-lasting indolent verrucous lesions and a history of exposure to sea water, freshwater, aquaria or fish.
海分枝杆菌引起的皮肤感染很少见。我们报告一例慢性广泛海分枝杆菌皮肤感染，其表现类似于着色芽生菌病，并复习相关文献。一位 52 岁的农民报告其右小腿有 32 年的慢性皮肤问题，起因是接触仙人掌。皮肤病变表现为色素减退性萎缩中心斑块和疣状边界，伴有血性结痂，从膝盖向前延伸至右腿下三分之一处。通过皮肤碎片的组织病理学检查、分枝杆菌培养和培养材料的基因图谱检测到海分枝杆菌感染。患者成功接受乙胺丁醇、利福平、复方磺胺甲噁唑治疗。海分枝杆菌感染的临床和组织病理学表现是非特异性的，具有临床多态性，在组织病理学检查中很少能见到杆菌。鉴于这些困难，在可疑病例中进行组织培养至关重要，对于有长期慢性疣状病变和接触海水、淡水、水族馆或鱼类病史的患者，应牢记这种感染。
