European Journal of Pediatrics

, Volume 177, Issue 9, pp 1389–1393 | Cite as

Mycobacterium marinum: a rare cause of chronic lymphocutaneous syndrome

  • Liad Avneri
  • Tal Eidlitz-Markus
  • Meirav Mor
  • Avraham Zeharia
  • Jacob Amir
  • Yishai Haimi-CohenEmail author
Short Communication


We investigated the prevalence of Mycobacterium marinum lymphadenitis and describe 4 children with the disease. The database of the microbiology laboratory of a tertiary pediatric medical center was searched for all cases of nontuberculous mycobacterial lymphadenitis from 1996 to 2016. M. marinum lymphadenitis was defined as isolation of the pathogen from a lymph node or from a skin lesion with an enlarged regional lymph node. M. marinum was isolated from lymph nodes in 2 of 167 patients with nontuberculous mycobacterial lymphadenitis and from skin lesions in 2 children with skin lesions and regional reactive lymphadenitis, yielding a 2.4% prevalence of M. marinum lymphadenitis. All 4 affected children were younger than 7 years and had been referred for evaluation of enlarged lymph nodes. Preauricular/submandibular and inguinal lymph nodes (n = 2 each) were involved. Three patients had skin traumas and visited the same natural spring. The diagnosis was delayed because a history of aquatic exposure was initially missed. Two children were managed with anti-mycobacterial antibiotics and 2 by observation only. All showed good resolution.

Conclusion: A detailed history, specifically regarding exposure to spring water sources, in cases of lymphocutaneous syndrome can point to the diagnosis of M. marinum infection.

What is Known:

M. marinum can cause chronic nodular or ulcerative skin infections.

Lymphadenitis due to M. marinum has rarely been reported.

What is New:

M. marinum infection can present as isolated chronic lymphadenitis; it accounts for about 2.4% of all cases of nontuberculous mycobacterial lymphadenitis and it tends to occur in noncervicofacial regions relative to infections of other nontuberculous mycobacterial species.

Careful history taking including water source exposure, especially in association with skin trauma, can point to the correct diagnosis in children with chronic lymphadenitis.


Nontuberculous mycobacteria Lymphadenitis Mycobacterium marinum 


Authors’ contributions

Liad Avneri: drafted the manuscript, data collection

Tal Eidlitz-Markus: technical assistance, data collection

Meirav Mor: drafted the manuscript, data collection

Avraham Zeharia: technical assistance, revision of the manuscript

Jacob Amir: study design, revision of the manuscript

Yishai Haimi-Cohen: study design and drafted the manuscript

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the ethics committee of Rabin Medical center and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Aubry A, Chosidow O, Caumes E, Rober J, Cambau E (2002) Sixty three cases of Mycobacterium marinum infection. Arch Intern Med 162:1746–1752CrossRefPubMedGoogle Scholar
  2. 2.
    Brady RC, Sheth A, Mayer T, Goderwis D, Schleiss MR (1997) Facial sporotrichoid infection with Mycobaterum marinum. J Pediatr 130:325–326CrossRefGoogle Scholar
  3. 3.
    Brown J, Kelm M, Bryan LE (1977) Infection of the skin by Mycobacterium marinum: report of five cases. Can Med Assoc J 117:912–914PubMedPubMedCentralGoogle Scholar
  4. 4.
    Gaglani MJ, Ballay T (1999) Picture of the month. Mycobacterium marinum facial abscess. Arch Pediatr Adolesc Med 153(5):543–544. CrossRefPubMedGoogle Scholar
  5. 5.
    Harris DM, Keating MR (2009) Mycobacterium marinum: current recommended pharmacologic therapy. J Hand Surg Am 34(9):1734–1735. CrossRefPubMedGoogle Scholar
  6. 6.
    Holland AJ, Holland J, Martin HC, Cummins G, Cooke-Yarborough C, Cass DT (2001) Noncervicofacial atypical mycobacterial lymphadenitis in childhood. J Pediatr Surg 36(9):1337–1340. CrossRefPubMedGoogle Scholar
  7. 7.
    Kuhn SM, Rosen W, Wong A (1995) Treatment of Mycobacterium marinum facial abscess using clarithromycin. Peditar Infect Dis 14:631–632CrossRefGoogle Scholar
  8. 8.
    Margileth AM (1983) The use of purified protein derivative mycobacterial skin test antigens in children and adolescents: purified protein derivative skin test results correlated with mycobacterial isolates. Pediatr Infect Dis 2(3):225–231. CrossRefPubMedGoogle Scholar
  9. 9.
    Margileth A, Chandra R, Altman P (1984) Chronic lymphadenopathy due to mycobacterial infections. Am J Dis Child 138:917–922CrossRefPubMedGoogle Scholar
  10. 10.
    Sigalet D, Gordon L, Fanning A (1992) Aypical tuberculosis in the pediatric patient: implications for the pediatric surgeon. J Pediatr Surg 27:1381–1384CrossRefPubMedGoogle Scholar
  11. 11.
    Tebruegge M, Curtis N (2012) Mycobacterium species non-tuberculosis. In: Long SS, Pickering LK, Prober CG (eds) Principles and practice of pediatric infectious diseases, 4th edn. Churchill Livingstone, Philadelphia, pp 786–792Google Scholar
  12. 12.
    Tebruegge M, Connell T, Ritz N, Orchard D, Curtis N (2010) Mycobacterium marinum infection following kayaking injury. Int J Infect Dis 14(Suppl 3):e305–e306CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Liad Avneri
    • 1
    • 2
  • Tal Eidlitz-Markus
    • 2
    • 3
  • Meirav Mor
    • 2
    • 4
    • 5
  • Avraham Zeharia
    • 2
    • 3
  • Jacob Amir
    • 1
    • 2
  • Yishai Haimi-Cohen
    • 2
    • 3
    • 5
    Email author
  1. 1.Department of Pediatrics CSchneider Children’s Medical Center of IsraelPetach TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  3. 3.Day Hospitalization DepartmentSchneider Children’s Medical Center of IsraelPetach TikvaIsrael
  4. 4.Emergency DepartmentSchneider Children’s Medical Center of IsraelPetach TikvaIsrael
  5. 5.Infectious Diseases UnitSchneider Children’s Medical Center of IsraelPetach TikvaIsrael

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