title: The fish tank strikes again: metachronous nontuberculous mycobacterial skin infection in an immunosuppressed host.
abstract: An 82-year-old woman on long-term prednisolone for chronic obstructive airways disease presented with a 2-month history of nodules on her left forearm. This occurred 10 years after nodules on her right forearm caused by a culture-proven Mycobacterium marinum infection. Histopathological examination, polymerase chain reaction and culture of biopsy specimens were positive for M. chelonae. To our knowledge this is the first case of metachronous nontuberculous mycobacterial skin infection reported, and it highlights the diagnostic and therapeutic challenges of such infections.
authors.affiliation: Department of Medicine (Dermatology), St. Vincent's Hospital Melbourne, Australia; Skin and Cancer Foundation Inc.
authors.forename: Jane
authors.initials: J
authors.lastname: Li
authors.forename: Alvin H
authors.initials: AH
authors.lastname: Chong
authors.forename: Rod
authors.initials: R
authors.lastname: O'Keefe
authors.forename: Paul D R
authors.initials: PD
authors.lastname: Johnson
mesh_terms: D000369:Aged, 80 and over; D000818:Animals; D005260:Female; D005399:Fishes; D005542:Forearm; D006686:Hobbies; D006801:Humans; D016867:Immunocompromised Host; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology*; D016926:Mycobacterium chelonae; D019910:Mycobacterium marinum; D012008:Recurrence; D017192:Skin Diseases, Bacterial / Q000382:microbiology*
keywords: fish-borne skin disease; nontuberculous mycobacterial skin infection