infectious diseases
Nontuberculous Mycobacterial Infections
Cutaneous disease
Swimming pool granulomais a protracted but self-limited superficial granulomatous ulcerating disease usually caused byMycobacterium marinumcontracted from swimming in contaminated pools or from cleaning a home aquarium.M. ulceransandM. kansasiiare occasionally involved. Lesions, reddish bumps, enlarging and turning purple, most frequently occur on the upper extremities or knees. Healing may occur spontaneously, butminocyclineordoxycycline100 to 200 mg orally once/day,clarithromycin500 mg orally 2 times a day, or RIF plus EMB for 3 to 6 months have been effective againstM. marinum. Buruli ulcer,caused byM. ulcerans, occurs in rural areas of > 30 tropical and subtropical countries; most cases occur in West and Central Africa. It starts as a painless subcutaneous nodule, a large painless area of induration, or a diffuse painless swelling of the legs, arms, or face. The infection progresses to cause extensive destruction of the skin and soft tissue; large ulcers may form on the legs or arms. Healing may result in a severe contracture, scarring, and deformity. For diagnosis, polymerase chain reaction should be used. (7.5 mg/kg 2 times a day) is now the recommended treatment ( Cutaneous infection reference ). 