MICOBATTERIOSI DA M. MARINUM A DISPOSIZIONE SPOROTRICOIDE IN DUE PAZIENTI IMMUNOCOMPETENTI

The paper reports two cases of patients referred to our department due to the presence, in the first for 6 months and in the second for 2 months, of multiple erythemato-nodular lesions with a sporotrichoid pattern on the upper limbs. Both patients tested the temperature of their acquariums daily. Anti-Hiv test, lymphocytic typing and chest X-rays were all negative in both patients. The first patient was treated with amoxicillin taken orally, ciprofloxacin, fluconazonol, trimethoprin-sulfametoxazole and lastly with intralesional steroid injections. In spite of this therapy the lesions spread, covering the entire left upper limb. The second patient was referred to our attention after having received doxycycline treatment for one month. The histological examination of nodular lesions in both patients appeared to confirm a granulomatous lesion. A periadnexal polymorphous infiltrate was in fact observed, composed of lymphoplasmocytic and histiocytic cells with a few giant cells. Microbiological tests on biopsy material revealed numerous colonies of Mycobacterium marinum in both patients. Both patients were treated for 8 weeks with rifampin at an oral dose of 900 mg a day and isoniazid at an oral dose of 100 mg a day with a total resolution of dermatosis without any recidivation after an interval of 1 year and 8 months respectively.