| A paronychial granuloma on the left thumb, in a man who kept tanks of tropical fish, was followed by cutaneous nodules on the left upper limb and tender lymph nodes in the left axilla. mycobacterium marinum was isolated from the lesion on the thumb and also from the tank water. Subsidence of the lesions followed administration of trimethoprim and sulphamethoxazole. ( info) |
2/11. bacteremia due to comamonas species possibly associated with exposure to tropical fish. comamonas species are environmental gram-negative rods that grow forming pink-pigmented colonies. Despite their common occurrence in nature, they rarely cause human infection. We present a case of comamonas bacteremia that we think may have been related to tropical fish exposure. The patient was treated successfully with levofloxacin. ( info) |
3/11. Tropical fish tank granuloma. A case of tropical fish tank granuloma due to mycobacterium marinum is presented. The source, epidemiology, diagnosis and treatment are discussed. ( info) |
4/11. Two human cases of gnathostomiasis and discovery of a second intermediate host of gnathostoma nipponicum in japan. Two human cases of gnathostomiasis from ingestion of raw native Japanese loaches, Misgurnus anguillicaudatus, are reported. Seven early third-stage larval gnathostoma nipponicum were recovered from 3,098 loaches in the same district in which 2 human patients had obtained and eaten raw loaches. Encapsulated G. nipponicum larvae were also recovered from loaches infected under laboratory conditions. All 6 weasels captured in the same district in which the naturally infected loaches were found and where the humans had become infected were infected with adult worms of the same species. This is the first report of M. anguillicaudatus serving as a second intermediate host of G. nipponicum. ( info) |
| A 33-year-old fish fancier developed a protracted skin infection that ultimately was found to be caused by mycobacterium marinum. The organism was isolated from the lesion as well as from infected fish taken from his home aquarium. The lesion resolved after a six-week course of oral sulfamethoxazole and trimethoprim. Forty-four additional cases of culture-proved M marinum skin infections acquired from aquariums and reported in the English-language literature are reviewed. Almost universally, the lesions remained circumscribed and were either single nodular (14 patients) or multiple sporotrichoid (31 patients). diagnosis was supported by acid-fast smears (15 patients) and isolation of the organism from skin lesions (43 patients) or from fish (two cases). in vitro studies, as well as clinical outcomes, suggest sulfamethoxazole-trimethoprim or ethambutol hydrochloride plus rifampin to be the drugs of choice. ( info) |
6/11. Piscine adult nematode invading an open lesion in a human hand. The first case of an adult, parasitic nematode entering an open lesion is reported. A female dracunculoid, Philometra sp., invaded a puncture wound in a fisherman's hand while he was filleting an infected carangidae fish, Caranx melampygus, in hawaii. This accidental infection represents a previously unrecognized risk in handling uncooked, infected fish. ( info) |
| A case of fish tank granuloma is presented. A lesional biopsy sample yielded growth of mycobacterium marinum on Lowenstein's medium. Treatment with cotrimoxazole was successful. ( info) |
8/11. Insidious effects of a toxic estuarine dinoflagellate on fish survival and human health. The estuarine dinoflagellate pfiesteria piscicida gen. et sp. nov. produces exotoxin(s) that can be absorbed from water or fine aerosols. culture filtrate (0.22 microns porosity filters, > 250 toxic flagellated cells/ml) induces formation of open ulcerative sores, hemorrhaging, and death of finfish and shellfish. Human exposure to aerosols from ichthyotoxic cultures (> or = 2000 cells/ml) has been associated with narcosis, respiratory distress with asthma-like symptoms, severe stomach cramping, nausea, vomiting, and eye irritation with reddening and blurred vision (hours to days); autonomic nervous system dysfunction [localized sweating, erratic heart beat (weeks)]; central nervous system dysfunction [sudden rages and personality change (hours to days), and reversible cognitive impairment and short-term memory loss (weeks)]; and chronic effects including asthma-like symptoms, exercise fatigue, and sensory symptoms (tingling or numbness in lips, hands, and feet; months to years). Elevated hepatic enzyme levels and high phosphorus excretion in one human exposure suggested hepatic and renal dysfunction (weeks); easy infection and low counts of several T-cell types may indicate immune system suppression (months to years). pfiesteria piscicida is euryhaline and eurythermal, and in bioassays a nontoxic flagellated stage has increased under P enrichment (> or = 100 micrograms SRP/L), suggesting a stimulatory role of nutrients. Pfiesteria-like dinoflagellates have been tracked to fish kill sites in eutrophic estuaries from delaware Bay through the Gulf Coast. Our data point to a critical need to characterize their chronic effects on human health as well as fish recruitment, disease resistance, and survival. ( info) |
9/11. Operator safety during injection vaccination of fish. Reports of adverse health effects to vaccinators after self-injection of fish vaccine motivated the present study which aimed at identifying risk factors and improving risk management. Information was collected through interviews with members of professional vaccinator teams, and with physicians who had treated injured vaccinators. In addition, a questionnaire was distributed among salmon farmers. Professional vaccinators reported from one to more than 50 stabs or self-injections during the vaccination season. Two cases of hospitalization due to anaphylactic reactions are described. Self-injections occurred exclusively on fingers and hands. The clinical picture is classified into four categories according to the type and severity of the reaction. The overall risk of self-injection leading to serious health effects was low, although the data do not allow a precise estimate. The collected information suggests that allergic hypersensitivity reactions occurred in two vaccinators, whereas increasing tolerance was reported from others. No information indicating infectious reactions was obtained, suggesting that non-steroid anti-inflammatory drugs constitutes an appropriate therapy for self-injection events. The use of a safety bow attached to the syringe and improved training and awareness of personnel apparently have reduced the incidence of self-injection since this study was conducted. health risks for vaccinators have further been reduced by equipping vaccinators with adrenaline and the improved knowledge of local doctors regarding recommended treatment. ( info) |
10/11. Neurologic symptoms following Pfiesteria exposure: case report and literature review. Although the recently identified dinoflagellate, pfiesteria piscicida, may have neurotoxic effects on humans, the precise nature of the neurologic symptoms associated with varying levels of exposure is unknown. Toward this end, we review the neurologic symptoms of three Pfiesteria-exposed laboratory workers reported to data and compare them to the evaluation of an exposed waterman from maryland. The occupational exposure of a maryland waterman appears to produce a mild, reversible encephalopathy which predominantly affects functions associated with the frontal and temporal lobes. A comprehensive neurologic examination is recommended for all pfiesteria piscicida and morphologically related organism-exposed, symptomatic persons. ( info) |