Mycobacterium marinum infection in a lung transplant recipient

We report a case of Mycobacterium marinum infection in a lung transplant re cipient who presented with nodules on the hand and forearm following exposu re to fish-tank water of a superficial hand burn. Skin biopsy revealed gran ulomatous inflammation and fibrosis. Tissue culture grew Mycobacterium mari num. The patient underwent surgical excision of the lesions and treatment w ith ethambutol and azithromycin for 12 months and experienced complete reso lution of the infection. Transplant recipients who receive immunosuppressiv e therapy are at increased risk for opportunistic infections. For a patient with nodular lesions on the extremities, exposure to fish, fish-tank water , or swimming should suggest infection with Mycobacterium marinum.