Emerging causes of superficial and invasive infections following marine injuries and exposures.

Soft tissue bacterial infections following aquatic animal bites, stings, and minor injuries occur commonly and usually on the extremities in fishermen and beachgoers worldwide after freshwater and saltwater exposures. Louisiana has more tidal, saltwater, and brackish water shorelines (more than 7,000 miles) than any other state, including Alaska and Hawaii. As a result, Louisiana residents are often exposed to marine pathogens when fishing or working offshore or when enjoying Louisiana's miles of shorelines. Although many species of bacteria have been isolated from marine wounds, superficial soft tissue and invasive infections following marine injuries and exposures are most commonly caused by a small number of bacterial species, including Aeromonas hydrophila, Edwardsiella tarda, Erysipelothrix rhusiopathiae, Mycobacterium marinum, and Vibrio vulnificus. In addition to these species, several other aquatic bacteria have recently been identified as emerging causes of superficial and invasive infections following marine injuries and exposures, including marine mammal (dolphins and seals) Brucella species, Chromobacterium violaceum, Comamonas species, Shewanella algae, and Streptococcus iniae. The objectives of this review are to describe the epidemiology, presenting clinical manifestations, diagnostic and treatment strategies, and outcomes of both the superficial and the deeper invasive infections caused by the newly emerging marine bacterial pathogens.