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July 4th, 2011, 06:50 PM | #1 |
Egg
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Tank related injury report part 1
Date: Mon, 4 Jul 2011 16:25:23 -0400 (EDT)
From: ProMED-mail <promed@promed.isid.harvard.edu> Subject: PRO/AH/EDR> Mycobacterium marinum, fish tank - USA: (CA) MYCOBACTERIUM MARINUM, FISH TANK - USA: (CALIFORNIA) ************************************************** ** A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> Date: Wed 15 Jun 2011 Source: ABC News Medical Unit [edited] <http://abcnews.go.com/Health/Wellness/flesh-eating-fish-tank-bacteria-lead-teens-amputation/story?id=13837034> What started as a small scrape from a corner of the family's fish tank 5 years ago may end in the amputation of a champion teen gymnast's hand. [The 13 year old girl] from Oak Hills, California, has battled a rare, flesh-eating infection she contracted from the tank when she was 8 and doctors have been unable to stop it from spreading. The bacterium has now spread to the bones of her right hand. "I can't use that hand at all. I'm in pain all the time," says Hannele. Over the years, the infection has forced her to quit sports like volleyball and gymnastics, despite having won an American Athletic Union gymnastics championship. The infection has become so severe that the 8th grader has been unable to write or do school work because her dominant hand is constantly shaking with pain. _Mycobacterium marinum_, sometimes referred to as fish tank granuloma, usually eats away at only the surface of the skin. But in this case it has infected several bones in her right hand, a development that could mean amputation of her right hand. Doctors at the Loma Linda Medical Center and UCLA Medical Center have tried multiple types of antibiotics and 2 surgeries to remove infected tissue, but the bacterium seems to have become drug-resistant. Fearing she may be infected with a "superbug" strain of the bacteria, the Cox family is seeking further treatment for her with infectious disease experts at Denver, Colorado's National Jewish Health medical center next week [week of 20 Jun 2011]. The ordeal began when [the girl] was only 8 years old, playing in the fish tank that resides in the family's living room. "She had already gotten in trouble a few times that week for sticking her arm in the fish tank," says her mother. "So when she cut her hand on it she hid it from me for a few days because she was worried about getting in trouble. By the time I saw it, it was red and purple and oozing with yucky green stuff. I soaked it in peroxide, but the cut wouldn't go away." It took months for doctors to recognize that the wound was infected with _M. marinum_. They originally thought it was a staph infection or even MRSA [methicillin-resistant _Staphylococcus aureus_]. Then came multiple rounds of antibiotics, some of which made [the teenager] so sick that she had to quit sports. These drugs and 2 surgeries on her hand have been powerless against this strain of the bacteria, however. _M. marinum_ infection is a distant cousin to more serious infections like tuberculosis and leprosy, but it is "exceedingly rare" for it to persist and travel deeper into the tissue as it has in this case, says Dr Michael Iseman, infectious disease expert at National Jewish Health in Denver, Colorado. "The fact that she's had multiple surgeries suggests that this is a more virulent, drug-resistant strain than most," he says. The bacterium can be found in salt or fresh water and has historically been associated with surfboarding and more recently, fish tanks. The bacterium is harmless unless introduced into an open wound and infections are relatively rare, says Dr William Schaffner, chair of the department of Preventive Medicine at Vanderbilt University School of Medicine. _M. marinum_ infections can sometimes heal on their own, but "it's a long-lasting infection and, without treatment, it can take one to 2 years to resolve," says Schaffner. Treatment consists of combinations of antibiotics and surgery. Mild skin infections with _M. marinum_ are well known among aquarium hobbyists, but the most famous disease risk among aquarium enthusiasts is salmonella, says Dr Christopher Ohl, MD, an infectious diseases expert at Wake Forest University School of Medicine. Salmonella outbreaks have been periodically tied to fish, amphibian, and reptile pets and the tanks they reside in; the most recent of which occurred this April [2011] when 216 people contracted salmonellosis from pet African dwarf water frogs. Overall, however, fish tanks "pose very little risk" when properly maintained, notes Schaffner. He recommends wearing latex gloves while cleaning pet tanks and washing hands and forearms with soap and water afterwards. Ohl also recommends cleaning tanks outside or in a bathtub -- not in the kitchen sink, to reduce the risk of contamination. Wash the bathtub with bleach afterwards if used, he says. If you get a cut while cleaning a fish tank, wash the wound with soap and water immediately. [byline: Courtney Hutchison] - -- Remainder of the post continues in reply
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