1 Instituto Lauro de Souza Lima, Rodovia Comandante João Ribeiro de Barros, km 225/226, Bauru CEP 17.034-971, SP, Brazil

2 Department of Public Health, Botucatu Medical School, UNESP – Univ Estadual Paulista, Av. Prof. Montenegro Bairro: Distrito de Rubião Junior, Botucatu, s/n - 18618970, SP, Brazil

ABSTRACT

The infection by Mycobacterium marinum in humans is relatively uncommon. When it occurs, it mainly affects the skin, usually with a chronic, indolent and benign evolution. The diagnosis requires a high index of suspicion, and a significant delay may be observed between the first symptoms to the final diagnosis. This present case reports a M. marinum infection in an immunocompetent patient that had a chronic undiagnosed injury on the dominant hand for at least five years. The patient had several medical consultations, without proper suspicion, hampering adequate diagnostic investigation. Histopathology detected tuberculoid granulomas, but showed no acid-fast bacilli. The culture in appropriate medium and the polymerase chain reaction-restriction enzyme analysis (PRA)-hsp65 confirmed the diagnosis. Treatment with clarithromycin (1 g/day) for three months was effective. Although uncommon, this infection is a contact zoonosis. Therefore, it is important for clinicians to be aware of this diagnosis and properly guide preventable measures to professionals that are in risk group.

Key words: Mycobacterium infections; Mycobacterium marinum; Case report; Granuloma