mycobacterium marinum

ghostman

ghostman

New member
Hello All,
I don't personally know many of you, but love reefkeeping and have been doing it for 15+years. I've been out of the hobby for a few months. You'll soon see why.
I just wanted to pass along my experience with mycobacterium marinum that I caught from my coral tank. It started as a small raised bump by my index finger nail. I did not scrape or injure my hand in any way. The bump gradually receded, but I developed large, sometimes painful swellings on the back of my right hand. They were about 1" to 2" and would swell/recede on different days. I play hockey, and considered them to be a hand injury of some kind. I took x-rays, which were negative.
After 6 weeks I began to suspect the mycobacterium marinum infection, and had my hand operated on the same day that I saw my doctor. They removed 2 lesions that were attached to the tendons of my right index and middle finger. I had 18 stitches and significant post surgery swelling of the area, so much so that my stitches burst and had to be redone. Biopsies of them showed granular tissue (no tumor ), and I have to wait 5-6 weeks for a culture of mycobacteria marinum to show up. In the meantime, I am on 2 antibiotics that are hard on the body. I will be on them for 2 months or more. The antibiotics also carry a risk of degenerative colitus in the future.
My tank has suffered from a lack of attention. I was seriously contemplating taking it down, but have now realized that I still love the hobby. I bought several pair of full length gloves from PA, and they should be arriving today. I have lost several SPS in the meantime. LPS, softies and fish are loving the dirty tank though:-)
In short, I would just like to remind everyone to be careful putting their hands in the tanks. Please print out an article on mycobacterium marinum to show to your doctor if you notice anything unusual. My doctor never saw it before, and probably would not have given me proper care until it was too late. Here's some pics that aren't too gross:-) Take care...Joe

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thanks for the info i have never heard of this before. i will definatly keep my eyes open for anything that is not normal!

Thanks for sharing
 
wow, this looks painful. Thanks for sharing your experience and warnings. Hope that you get well soon.
 
Just wanted to provide an update on this as I would hate any other reefers to go through what I have gone through with this. Basically, mycobacterium marinum is a bacterial infection that can be caught through contact with your fish tank. Mine likely appeared from a scratch on my right index finger from the live rock. I think we all have had that happen!! My finger never caused a problem, but I did develop swellings on the back of my hand which required surgery. There is no typical course of antibiotics, but a combination of sulfa and rifampin seems to work well ( but the side effects are killers ). Here is a picture after a month, with almost no reduction in the size of the lesions. I probably have several more months of antibiotics until this thing is gone. I now wear thick, arm length gloves and minimize my tank water contact. Just an FYI. Our tanks could KILL US!!!!!!! OK, maybe not, but it can make you sick:-) BTW, I decided to continue reefkeeping, but was on the fence for a while. The addiction is too strong:-) Happy Reefing!!!!
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looking back at my photo, it is hard to tell how bad the nodules look:-( I have a raised area the size of a dime above my index finger, and a raised area above my middle finger the size of a quarter. They are raised about 1/4". Think of it as a single eye chalice frag, and chalice mini colony stuck to the back of my hand:-) That analogy seems appropriate:-)
 
ghostman said:
looking back at my photo, it is hard to tell how bad the nodules look:-( I have a raised area the size of a dime above my index finger, and a raised area above my middle finger the size of a quarter. They are raised about 1/4". Think of it as a single eye chalice frag, and chalice mini colony stuck to the back of my hand:-) That analogy seems appropriate:-)
Click to expand...

That is funny. I dont think you will ever be able to give up this hobby. I am just glad everything turned out ok.
 
I have had several such infections. The first time I was in the hospital for a week and my hand felt like it was going to explode. They had to lance it to keep it from doing so. Other times when I noticed it Augmentin seemed to do the trick. Now we keep antibacterial soap by all our sinks and any time anyone gets scratched they have to wash with it immediately.
R.O. water is also a source of infections since we have removed the chlorine from it.
 
Just wanted to provide an update in my battle with the mycobacterium infection. It has not responded well to antibiotics and I had to have another surgery. My doctor removed a mass about the size of 2 lima beans and we are going to culture it to determine which course will work against it. Here's some before and after pics again. The back of my hand is looking like a road map:-)
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Just out of curiosity, are you sure it is from the tanks and not something that was waiting to happen like cancer? I mean, you never know then THAT sh!t is gonna hit or where, so, same thing but different. Dont get me wrong, I know stuff in our tanks can do some crazy stuff. I just wonder why it hasnt traveled around your body, thank goodness and popped up all over? Then again, I guess hands in the tank and absorbing through the skin, well, there you go........
 
Hey csmfish. I'm actually an oncologist (cancer doctor) and looked into that right away. There are very few, rare cancers that appear on the back of the hand, such as Giant cell. Biopsies taken of the nodule came back negative for cancer, and actually came back negative for myco marinum the first time. It is a very difficult strain to culture and took several weeks to get a proper diagnosis.
 
I didn't see this until now but let me know if you need help with your tank. I travel a lot but can help when I am home. I know we talked in a thread before but just thought I would throw it out there. Also if you ever have an emergency and need backup water or equipment I'd be happy to help.

Have you finally beat this thing?
 
Interesting that it came back negative the first time but positive for m. marinum the second time. I am interested to know where you think the error was made (doctor's error, lab's error, etc.)? We rely so heavily on lab tests and I am always interested in seeing where things can go wrong in this area (for the purposes of learning from mistakes).

Hope your recovery is going well.
 
Thanks for the offer kawicivic, we have to meet sometime and do a little frag swapping:-) I'm going to be moving soon, and might upgrade tanks-maybe BIG!!!! I haven't beat the infection yet, but it is hard to tell. My hand is so full of scar tissue underneath, that some of the bumps might never go away even if they are not carrying the infection.

The mycobacterium is very hard to culture in the lab, with less than a 70% success rate in perfect cultures. More often than not, physicians that feel they are dealing with MM use clinical, visual findings rather than perfect empirical data. I started my antibiotics well before I had an actual, solid diagnosis. We "knew" what it was, even before the lab test confirmed it. As indicated in the first post, I never scraped my hand on live rock or anything like that. I do have small cuts and scrapes from normal everyday life, and that is probably how it got there.
 
I'm also curious about which Antibiotics work(ed)? Has anything outside of the penicillin family worked?

With a TypeII allergy to the stuff, it's not an option for such a course of treatment. With some google searching the common alternatives are options, just wondering if they are an option which actually works.
 
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Ghost I'm glad you are ok. It doesn't look like fun and not knowing if this last operation will do it would drive me nuts.
Good Luck!
 
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