Swimming pool granuloma
Alternative Names
Aquarium granuloma; Fish tank granuloma
Definition
A swimming pool granuloma is a long-term (chronic) skin infection. It is caused 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 painful nodule.
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 sometimes occur. 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 skin that do not clear with home treatment.
Prevention
Wash hands and arms thoroughly after 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.