A Case of Mycobacterium Marinum Infection Successfully Treated with Clarithromycin

Abstract

A 23-year-old woman developed abscesses and several red nodules on her right upper extremity. She had been breeding tropical fish for several years. A histological examination of one of these red nodules revealed epithelioid cell granuloma. and Mycobacterium marinum was detected from the same biopsy specimen, as well as from the tropical fish and the water from the fish tank. The administration of oral minocycline (200 mg/day) was started. However minocycline was discontinued 9 months later because of its ineffectiveness. Thereafter, oral clarithromycin 800 mg daily was given, eventually resulting in complete resolution of the lesions 4 months later. One hundred and fifty cases of M. marinum infection have been reported in Japan from 1964 to 1997. However, no case was treated with clarithromycin alone. Therefore, this is the first report of the successful treatment of atypical mycobacterial infection with clarithromycin alone.