Mycobacterium marinum tenosynovitis: three case reports and review of the literature.

Mycobacterium marinum is one of the nontuberculosis mycobacteria responsible for skin infections. There have been very few case series of M. marinum infections reported in the English literature. Herein, we describe three patients with M. marinum tenosynovitis. All patients had positive cultures and were exposed to pricking by a fishbone. The incubation period ranged from 7 to 60 days. Key elements in the diagnosis of this infection were a high index of suspicion raised by negative bacterial tissue cultures, poor response to conventional antibiotics treatment, a history of exposure to tropical fish and tissue biopsy for culture and histology. The treatment is essentially antimicrobial therapy supplemented by an appropriate surgical debridement, especially when deep structures are involved.