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European Journal of Dermatology

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Rapid identification of Mycobacterium marinum by comparative 16S-rRNA-gene analysis in five cases of progredient cutaneous infections Volume 7, issue 4, June 1997

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Authors
Institute of Medical Microbiology, Johannes-Gutenberg-Universität Mainz. Hochhaus am Augustusplatz, D-55101 Mainz, Germany.

Five cases of Mycobacterium marinum infection were diagnosed by automated sequencing of 16S-rDNA at our Department of Medical Microbiology over a period of 10 months. This compares to a single case of Mycobacterium marinum infection recorded during the five years prior to the availability of this method at our clinic. While all of the patients shared typical features of fishtank granuloma, such as cutaneous lesions on an upper extremity, contact with aquatic organisms and wounds or scratches as potential portals of entry, none of the cases was diagnosed by the physicians who were initially consulted. This could partially be attributed to the different characteristics exhibited in some of the cases. All of the patients showed a marked improvement of their symptoms within several weeks under specific antibiotic treatment with combinations of rifampin, ethambutol and clarithromycin. The availability of 16S-rDNA-sequencing as a rapid and precise procedure for the identification of atypical mycobacteria is considered to be an incentive for the clinician to pursue more rigorously, an accurate diagnosis of such cutaneous lesions.