Successful treatment of refractory cutaneous infection caused by Mycobacterium marinum with a combined regimen containing amikacin

Figures & data

Figure 1 Skin lesions. (A and B) Before treatment a large area of immersed erythema and edema with nodules, ulcerations, and crusts scattered on the right upper limb was present. A nummular deep ulcer with a severe tenderness presented on the back side of the second digit. (C and D) After 2 months of therapy the skin nodules decreased in size and the ulcer cavity was filled with fresh tissues. (E and F) After 6 months of therapy the lesions subsided, leaving some hyperplastic scars.

Figure 2 Pathological changes.

Note: A neutrophilic and histiocytic granuloma (hematoxylin and eosin; original magnification ×400).

Figure 3 Pathogenic organism. (A) Mycobacterial cultures from the isolated lesional skin. (B) Smear from the cultured organisms with acid-fast stain.

Figure 4 Restriction analyses of the isolated strain amplification products.

Notes: Lanes 1 and 8, DNA size marker (100 bp ladder); lanes 2 and 5, undigested amplification products of the isolated strain and Mycobacterium marinum (439 bp); lanes 3 and 6, BstEII digestion of the isolated strain and M. marinum (245/220 bp); lanes 4 and 7, HaeIII digestion of the isolated strain and M. marinum (160/115/80 bp).