TITLE:
Tenosynovitis and Sporotrichoid Disease Due to M. marinum on a Patient under Anti-TNFα Therapy
AUTHORS:
Diana Póvoas, J. Machado, F. Maltez
KEYWORDS:
Mycobacterium marinum; Anti-TNFα Drugs
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.3 No.4,
December
19,
2013
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.