title: Disseminated cutaneous and synovial Mycobacterium marinum infection in a patient with systemic lupus erythematosus.
abstract: A patient with systemic lupus erythematosus had a protracted skin infection with Mycobacterium marinum after a puffer fish sting. Disseminated cutaneous and synovial disease was associated with clinically active systemic lupus erythematosus two years after the initial infection. The infection was poorly responsive to multiple antituberculous regimens. Hematogenous spread of infection was the likely route of dissemination.
authors.affiliation: Department of Medicine, Tripler Army Medical Center, Honolulu, Hawaii.
authors.forename: R J
authors.initials: RJ
authors.lastname: Enzenauer
authors.forename: J
authors.initials: J
authors.lastname: McKoy
authors.forename: D
authors.initials: D
authors.lastname: Vincent
authors.forename: R
authors.initials: R
authors.lastname: Gates
mesh_terms: D000328:Adult; D000818:Animals; D002481:Cellulitis / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D005260:Female; D005397:Fish Venoms / Q000009:adverse effects; D005400:Fishes, Poisonous / Q000382:microbiology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008911:Minocycline / Q000627:therapeutic use; D009164:Mycobacterium Infections / Q000150:complications*; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification; D012874:Skin Diseases, Infectious / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D013585:Synovitis / Q000188:drug therapy / Q000209:etiology*; D052256:Tendinopathy / Q000188:drug therapy / Q000209:etiology*; D014953:Wrist
chemical_list: D005397:Fish Venoms; D008911:Minocycline