Swimming Pool Granuloma (Granulomatous Mycobacteriosis). Presented by Stanton B. May, MD.
A 48-year-old white man had a reddish, nodular, dry plaque over the right middle knuckle for 15 months. Before the onset, he recalled that he cut his right hand in an aquarium. The area was excised by an orthopedic surgeon two years ago, followed by a recurrence at the margin. A culture, prepared at the time of surgery, grew Mycobacterium marinum. The plaque now is almost 3 cm in diameter, nodular, scaly, erythematous and movable, with a tendency to central clearing. Therapy has included solidified carbon dioxide and heat applications.
Dr. Victor D. Newcomer: Among the clinical diagnoses to be considered would be tuberculosis verrucosa cutis and various types of granulomas due to bromide, silica, beryllium, zirconium, and dental floss. The history of injury to the hand in an aquarium and the culture of an atypical Mycobacterium organism