MYCOBACTERIUM-MARINUM ARTHRITIS

Mycobacterium marinum is an atypical acid-fast organism that is rarely associated with septic arthritis. Most often this is seen in patients with monarticular synovitis of the hands or wrists, especially in ass ociation with a history of periarticular trauma or exposure to marine environments. From tissue obtained by aspiration or synovectomy, Mycob acterium marinum can be identified by Ziehl-Nielson stain and has opti mal growth in Lowenstein-Jenson medium. Therapy should consist of at l east two antimycobacterial agents for a minimum 6 months. Surgical deb ridement also may be beneficial. The clinician must have a high index of suspicion that exposure to Mycobacterium marinum has occurred so ap propriate stains and cultures can be obtained. Copyright (C) 1995 by W .B. Saunders Company