Swimming pool granuloma

Fish tank granuloma, aquarium granuloma, swimming pool granuloma, fish tank granuloma, fish fancier's finger, surfers' nodules, fish-handlers' nodules.

Atypical mycobacteriosis. Infectious disease caused by Mycobacterium marinum. Contact with mostly tropical ornamental fish is indicative for the diagnosis.

• Inoculation of the pathogens through small skin lesions when cleaning an aquarium, or when swimming, diving etc. 
• Pathogen: Mycobacterium marinum (syn. Mycobacterium balnei).

• Erythematous bluish, ulcerative nodule or granuloma. Spread from the skin to deeper tissues incl. joints and bones is possible.

• Clinic.
• Biopsy with dermatopathological and microbiological work-up.

• Acres, back of the hand, elbow, back of the foot and knee.

Tubercle with central necrosis.

• Spontaneous healing after 12-24 months.

• Prophylaxis
• Wearing gloves when cleaning the aquarium.

1. Van Dyke JJ , Lake KB. Chemotherapy for aquarium granuloma. JAMA 1975;233:1380-1.
2. Contorer P , Jones RN. Minocycline therapy of aquarium granuloma. Case reports and literature review. Cutis 1979;23:864-8.
3. Engbaek HC, Thormann J , Vergmann B. Aquarium-borne Mycobacterium marinum granulomas. Scand J Infect Dis 1980;12:74-8.
4. Streit M, Bohlen LM, Hunziker T, Zimmerli S, Tscharner GG, Nievergelt H et al. Disseminated Mycobacterium marinum infection with extensive cutaneous eruption and bacteremia in an immunocompromised patient. Eur J Dermatol 2006;16:79-83.
5. Iyengar KP, Matar HE, Jayeola AO , Loh WY. Flexor pollicis longus tenosynovitis caused by Mycobacterium marinum infection. BMJ Case Rep 2014;2014.
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