Marine Develops Chronic Right Knee Granuloma After Initial Injury at The Basic School.

Marine Develops Chronic Right Knee Granuloma After Initial Injury at The Basic School. Mil Med. 2018 Mar 14;: Authors: Prak AH, Dela Rosa KM Abstract With skin lesions that have failed previous treatments, consideration for an atypical mycobacteria, specifically Mycobacterium marinum, infection should be suspected. Importance of the history cannot be stressed as this is a clue that the patient may have been inoculated and infected in the field environment. A marine with chronic right knee plaque for 3 yr that first appeared after a field exercise at The Basic School but worsened despite treatment with clindamycin, TMP-SMX, and incision and drainage in 2012. Examination revealed a 4 × 4 cm pink, pearly, scaly plaque with scabbing. Deroofing caused puncta to bleed and suppurate. Empiric therapy with doxycycline topical fluocinonide were initiated. Histopathological findings showed dermal fibrosis, granulomatous inflammation, and overlying epidermal inflammation and hyperplasia. Sections also revealed scattered admixed non-necrotizing granulomata. Initial stains, tissue and wound cultures were negative. Acid-fast bacilli broth and smear culture with growth after 4 wk, growing M. marinum. Doxycycline was continued for 2 more months. Mycobacterium marinum is a nontuberculous mycobacterium responsible for skin infections. Sources of infections usually are non-chlorinated water. Infections are rare, an estimated annual incidence of 0.27 ca...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research