INFECTIONS CUTANEES A MYCOBACTERIUM MARINUM. A PROPOS DE CINQ CAS

Five cases of Mycobacterium marinum skin infection in patients breeding exotic fish are reported. Lesions mimicking sporotrichoid nodules developed on the fingers, hands or forearms. Cutaneous biopsies revealed chronic inflammatory granulomas consisting of polymorphonuclear cells, lymphocytes, histiocytes, and epithelioid cells. Ziehl-Neelsen stain of the tissue sections was negative, but the bacteriological diagnosis was established on Lowenstein-Jensen media. After a few weeks incubation at 30°C, M. marinum photochromogenic colonies developed. These strains were sensitive to ethambutol, cycloserine, tetracycline, partly sensitive to rifampicin and highly resistant to streptomycin, P.A.S. and isoniazide. Successful treatment was achieved with tetracycline, or with antituberculous drugs (rifampicin, ethambutol, P.A.S.) followed or not by the administration of tetracycline. Diagnosis, treatment and epidemiology of the disease are reviewed.SCOPUS: ar.j