Korean J Dermatol.  2013 Sep;51(9):734-739.

A Case of Mycobacterium marinum Infection Diagnosed by PCR Amplification and Direct Sequencing

• Kim JY
• Seo SH
• Hwang EJ
• Choi M
• Park SS
• Seong MW
• Cho KH

Abstract

Mycobacterium marinum is an atypical mycobacterium (ATM) and is an uncommon cause of skin and soft tissue infections associated with contact with contaminated water. Diagnosis is often delayed when only a conventional identification method is used. PCR amplification and direct sequencing is recently available method for rapid identification of ATM. We report a case of M. marinum infection identified by PCR and sequencing. A 56-year-old female was referred for multiple erythematous nodules on both forearms which appeared two months ago. Skin biopsy showed suppurative granulomatous inflammation, and AFB culture showed nontuberculous Mycobacteria. PCR and sequencing were performed, and the obtained sequences were compared to the database using BLAST. The sequences of 16S rRNA and rpoB could not differentiate between M. marinum and M. ulcerans, showing 100% homology to both. Identification was possible using the sequences of the tuf and hsp65 genes, showing both 100% homology to M. marinum, while 99.8%, 99.7% to M. ulcerans. The patient was treated with clarithromycin, rifampicin, and ethambutol for 6 months.

Keyword

Atypical mycobacterial infection; Direct sequencing; Mycobacterium marinum; PCR; Swimming pool granuloma

MeSH Terms

Biopsy
Clarithromycin
Ethambutol
Female
Forearm
Humans
Inflammation
Middle Aged
Mycobacterium
Mycobacterium Infections, Nontuberculous
Mycobacterium marinum
Nontuberculous Mycobacteria
Polymerase Chain Reaction
Rifampin
Skin
Soft Tissue Infections
Clarithromycin
Ethambutol
Rifampin