title: Concurrent infection due to Shewanella putrefaciens and Mycobacterium marinum acquired at the beach.
abstract: Infection with marine bacteria is uncommon. A patient with systemic lupus erythematosus who developed concurrent infection with Shewanella putrefaciens and Mycobacterium marinum (M. marinum) is described. After bathing leg ulcers in sea water, severe cellulitis of the left leg with necrotic areas and extensive bullae developed. Infection due to S. putrefaciens was confirmed and a long course of hospitalization, oral ciprofloxacin and skin grafting was required. During hospitalization subcutaneous nodules developed on the other leg. Biopsy revealed acid-fast bacilli and culture grew M. marinum. These lesions responded to rifampicin and cotrimoxazole. Patients with leg ulcers, peripheral vascular disease, diabetes, or receiving immunosuppressive drugs may acquire unusual infections after salt water exposure.
authors.affiliation: Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Adelaide, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Papanaoum
authors.forename: G
authors.initials: G
authors.lastname: Marshmann
authors.forename: L A
authors.initials: LA
authors.lastname: Gordon
authors.forename: R
authors.initials: R
authors.lastname: Lumb
authors.forename: D L
authors.initials: DL
authors.lastname: Gordon
mesh_terms: D000368:Aged; D001493:Bathing Beaches; D016523:Foot Ulcer / Q000382:microbiology* / Q000628:therapy; D016905:Gram-Negative Bacterial Infections / Q000150:complications*; D006092:Gram-Negative Facultatively Anaerobic Rods / Q000302:isolation & purification*; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D019910:Mycobacterium marinum / Q000302:isolation & purification*