Uronema Marinum

Huskymaniac

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This thread is not what you think, lol. Went to my dermatologist today for a ulceration on my hand that was there for 4 weeks and not responsive to a week of bactrim. Although he was not 100% positive, waiting culture and biopsy, he thinks I have something called Fish Tank granuloma. This is called mycobacterial marinum. Is this the same thing that causes uronema in Chromis and Anthias? If so I must be the most unlucky person in the world since my chromis and anthias are all doing well, lol.
 

rkpetersen

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Not related to Uronema.
Mycobacterium marinum is more closely related to tuberculosis.
The body forms granulomas in response to Tb and other mycobacterial infections;
basically an attempt to wall off the infection when it can't be cured and all the bacteria eliminated directly.
 

Frtdrmrose7

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This thread is not what you think, lol. Went to my dermatologist today for a ulceration on my hand that was there for 4 weeks and not responsive to a week of bactrim. Although he was not 100% positive, waiting culture and biopsy, he thinks I have something called Fish Tank granuloma. This is called mycobacterial marinum. Is this the same thing that causes uronema in Chromis and Anthias? If so I must be the most unlucky person in the world since my chromis and anthias are all doing well, lol.
Did he recommend holding your hand in metroplex at 2 scoops per 10G for 14 days?
Sorry I had too, I would be interested to know what the culture comes back as though.
 

rkpetersen

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No I did ask him though if I should take chloroquine phosphate. Haha
If they can't cure it by excision, they may well prescribe isoniazid or rifampin.
Mycobacterial infections are notoriously difficult to cure.
For example, people who convert a Tb skin test but have no evidence of active tuberculosis still have to take isoniazid for 6-9 months to make sure it's gone.
 
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Huskymaniac

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Right now I am just on doxycycline. It seems pretty superficial to me. Just looked pretty gnarly.
 
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Huskymaniac

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Here is another question. Are all my fish sick with this disease also?
 

rkpetersen

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Here is another question. Are all my fish sick with this disease also?
Some or all of your fish may carry the organism, but that doesn't mean they'll ever be noticeably ill from it.
Mycobacteria in general are not highly virulent; they don't infect animals easily and when they do, they tend to grow slowly.
The very slow growth is part of the reason that these infections are hard to treat.
Not at all comparable to parasites like velvet, or even infections by 'normal' bacteria.
 
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Huskymaniac

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Do you think feeding them for the next month a combo of kanaplex and metro would do anything? Worthwhile or waste of time?
 

Frtdrmrose7

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Do you think feeding them for the next month a combo of kanaplex and metro would do anything? Worthwhile or waste of time?
If they aren’t actively sick I wouldn’t, our tanks are full of pathogens just like our environments that our immune systems handle.
 

rkpetersen

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Do you think feeding them for the next month a combo of kanaplex and metro would do anything? Worthwhile or waste of time?
Mycobacteria would just laugh at those antibiotics. ;Hilarious
 

Mjrenz

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This thread is not what you think, lol. Went to my dermatologist today for a ulceration on my hand that was there for 4 weeks and not responsive to a week of bactrim. Although he was not 100% positive, waiting culture and biopsy, he thinks I have something called Fish Tank granuloma. This is called mycobacterial marinum. Is this the same thing that causes uronema in Chromis and Anthias? If so I must be the most unlucky person in the world since my chromis and anthias are all doing well, lol.
@tdlawdo?
 
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Huskymaniac

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What good is a story without a picture. Yes, it's as gnarly as it looks.

20190506_193156.jpg
 

rkpetersen

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I'd be taking that pretty seriously. Hopefully biopsy and culture results will be available soon.
Regardless of what organism is in there, you need to be on the right antibiotic.
How did it start? Was there an open wound there already that got wet?
Or did you bump your uninjured hand against something sharp in the tank?
 
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Huskymaniac

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Biopsy can take 3 to 5 days and culture can take up to 3 weeks. That is why he did the biopsy because it can show features which he said would be enough for him to 100% diagnose. Right now I am doxycycline which is one of the antibiotics that treat it. The other thing that worries me is vibrio. I scrapped my hand on the overflow return line cleaning off algea. The scrape healed and I woke up to a small bump 2 weeks later. The bump turned to the above picture in literally 3 days. Hasn't changed much since then but I have had it drained once. Spent a week on Bactrim, and now Doxycycline. It hast gotten to the point of spreading down my arm so hopefully it will be short lived.
 
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Huskymaniac

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Here is another question. For the safety of my kids should I get rid of this tank and start over with everything brand new? Some people say this bacteria is omnipresent and others say it's not. A lot of conflicting information out there.
 

tdlawdo

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Not practicing medicine here just distributing some knowledge “as I see it”. Always refer to your physician for any treatment questions.

Sorry been traveling. Here is some info. Please ask your doctor to see an infectious disease doc as this generally requires dual therapy. Two antibiotics, one has to be what’s called a macrolide “zpack” or clarithromycin...and an add on doxy. These could change with a proper culture result. Having said that surgical intervention is also often warranted.

Mycobacterium marinum — Mycobacterium marinum, causes fish tuberculosis and contaminates the water of aquaria housing infected fish. Humans develop M. marinum infection, "fish tank granuloma", when they sustain a minor skin injury while cleaning a fish tank. Other atypical Mycobacteria species, primarily Mycobacterium fortuitum and Mycobacterium chelonae, cause a similar disease both in fish and man.

Human M. marinum infection presents as a cutaneous (skin) infection characterized by chronic skin papules, pustules, and ulcers that develop weeks following the injury.

As for the kids risk I think most would advise against reaching into the water for the kids.

Hope that helps. PM if you have specific questions.
 
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Huskymaniac

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So far my hand is still attached. I have 4 tanks that I am managing and none of the fish have any symptoms. On my main display I have a pentair 120 watt plumbed inline so from a bacterial pathogen risk would think that's not the tank since the bacterial load in that tank should be minimal. That is if the uv works. Could be the QT tank. Should I add the fish in QT to the display? So many questions and not a lot of information out there on what to do in this situation.
 

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M. marinum is likely in most aquariums. It is also found in swimming pools (no longer common with chlorination) and most bodies of water that are relatively stagnant.
This family of bacteria has many species. Not to scare you but Tuberculosis and Leprosy come from this genus.
My daughter had a M. avium infection when we had several parrots.
If your hand turns out to have an M marinum infection, it likely entered from a pre existing cut. It may take several weeks of specific antibiotics to heal the wound.
While I am not sure I doubt you can rid the tank of the organism.
Hope it gets better soon.

This is a pretty thorough article: https://www.tandfonline.com/doi/full/10.1080/01652176.2018.1447171
 

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