Fishy story: paradoxical reaction associated with Mycobacterium marinum

BMJ Case Rep. 2024 Aug 29;17(8):e261308. doi: 10.1136/bcr-2024-261308.

Abstract

Paradoxical reactions occur when an infection has acute worsening in response to antibiotic therapy. Here, we describe a patient with chronic cutaneous ulcerative lymphangitis that acutely worsened following initiation of antibiotic therapy. The infection was caused by Mycobacterium marinum, a species which has not previously been associated with paradoxical reaction in immunocompetent persons. In this case report, we describe our patient's diagnosis and management, review the management of Mycobacterium marinum infection, and discuss paradoxical reactions in mycobacterial disease.

Keywords: Dermatology; Immunology; Infectious diseases; TB and other respiratory infections.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents* / therapeutic use
  • Humans
  • Lymphangitis / diagnosis
  • Lymphangitis / microbiology
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous* / diagnosis
  • Mycobacterium Infections, Nontuberculous* / drug therapy
  • Mycobacterium marinum* / isolation & purification

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Infection with Mycobacterium marinum