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    Swimming pool granuloma

    Aquarium granuloma; Fish tank granuloma

    A swimming pool granuloma is a long-term (chronic) skin infection. It iscaused by the bacteria Mycobacterium marinum.

    Causes

    A swimming pool granuloma occurs when water containing Mycobacterium marinum bacteria enters a break in the skin. Signs of a skin infection appear about 2 - 3 weeks later.

    Risks include exposure to swimming pools, salt water aquariums, or ocean fish.

    Symptoms

    The main symptom is a reddish bump (papule) that slowly grows into a purplish and painfulnodule.

    The elbows, fingers, and back of the hands are the most common body parts affected. The knees and legs are less commonly affected.

    The nodules may break down and leave an open sore. Sometimes, they spread up the limb. Most often they stay a simple skin sore.

    Exams and Tests

    Tests to diagnose swimming pool granuloma include:

    • Skin test to check for tuberculosis infection, which may look similar
    • Skin biopsy and culture
    • X-ray or other imaging tests for infection that has spread to the joint or bone

    Treatment

    Antibiotics are used to treat this infection. They are chosen based on the results of the culture and skin biopsy.

    You may need several months of treatment with more than one antibiotic. Surgery may also be needed.

    Outlook (Prognosis)

    Swimming pool granulomas can usually be cured with antibiotics. However, you may have scarring.

    Possible Complications

    Tendon,joint or bone infections sometimesoccur. The disease may be harder to treat in patients whose immune system is not working well.

    When to Contact a Medical Professional

    Call your health care provider if you develop reddish bumps on your skinthat do not clear with home treatment.

    Prevention

    Wash hands and armsthoroughlyafter cleaning aquariums. Or, wear rubber gloves when cleaning.

    References

    Bhambri S, Bhambri A, Del Rosso JQ. Atypical mycobacterial cutaneous infections. Dermatol Clin. 2009;27:63-73.

    Brown-Elliott BA, Wallace RJ Jr. Infections due to nontuberculous mycobacteria other than Mycobacterium avium-intracellulare. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease. 7th ed. Philadelphia, PA: Elsevier Saunders; 2009:chap 253.

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              Review Date: 1/22/2013

              Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Stephanie Slon, and Nissi Wang.

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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              St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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