Tenosynovitis and Sporotrichoid Disease Due to M. marinum on a Patient under Anti-TNFα Therapy

Diana Póvoas, J. Machado, F. Maltez

Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal.
Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, EPE, Lisboa, Portugal..

DOI: 10.4236/aid.2013.34045                

Abstract

There have been several reports of tuberculosis (TB) and, less frequently, of nontuberculous mycobacterial (NTM) infections in association with tumor necrosis factor α inhibitor (anti-TNFα) therapy. Mycobacterium marinum is a NTM with a distinct epidemiology and is infrequently responsible for disease in humans. Most commonly, it causes localized skin infections, but in 20% to 40% of cases, it involves deeper structures. Disseminated disease is exceptional and has been reported to occur only in immunocompromised patients. The authors report a clinical case of tenosynovitis and sporotrichoid disease due to M. marinum in a 45-year-old male patient under anti-TNFα therapies for spondyloarthropathy. Along antimicrobial therapy, the patient underwent surgical debridement and after two years he is still on treatment but substantially improved. A few cases of M. marinum infection occurring in patients treated with anti-TNFα drugs have been reported. The diagnosis of infection due to M. marinum requires a high index of suspicion from a properly obtained exposure history and is important so that efficient diagnostic approach and treatment are ensured.

Keywords

Mycobacterium marinum; Anti-TNFα Drugs

Conflicts of Interest

The authors declare no conflicts of interest.

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