Background
- One of the non-tuberculous mycobacteria
- Environmental organism in fresh, brackish, or salt water
- Acquired through inoculation
- Rare cause of disease in humans
- Occupational risk of biologists, veterinarians, and fishermen
Clinical Manifestations
- Typically presents with nodular lymphangitis after exposure to fresh- or saltwater, including aquarium water ("fish tank granuloma")
Differential Diagnosis
- Other causes of nodular lymphangitis
Management
- For simple, localized lesion, can treat with monotherapy: clarithromycin, TMP-SMX, or doxycycline
- For other lesions, treat with combination clarithromycin and either ethambutol or rifampin
- Duration is for 1 to 2 months after resolution of lesions (typically 3 to 4 months total)
