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Swimming pool granuloma

Contents of this page:

Alternative Names   

Aquarium granuloma; Fish tank granuloma

Definition    Return to top

A swimming pool granuloma is a long-term (chronic) skin infection caused by the bacteria Mycobacterium marinum.

Causes    Return to top

A swimming pool granuloma occurs when water containing Mycobacterium marinum bacteria enters a break in the skin. A skin infection occurs about 3 weeks later.

Risks include exposure to swimming pools, salt water aquariums, or ocean fish.

Symptoms    Return to top

The main symptom is reddish bumps (papules) that slowly grow into purplish nodules.

The elbows, fingers, and back of the hands are the most common body parts affected. The knees and legs are less commonly affected.

The nodules may break down and leave an open sore. Or they may spread up the limb.

Exams and Tests    Return to top

Tests to diagnose swimming pool granuloma include:

Treatment    Return to top

Antibiotics are used to treat this infection. They are chosen based on the results of the culture and skin biopsy.

You may need several months of treatment with a combination of antibiotics. Surgery may also be needed.

Outlook (Prognosis)    Return to top

Swimming pool granulomas can usually be treated completely with antibiotics.

Possible Complications    Return to top

Occasionally, joint or bone infections occur. The disease may be longer or more complicated in patients whose immune system is not working properly.

When to Contact a Medical Professional    Return to top

Call your health care provider if you develop reddish bumps on your skin which do not clear with home treatment.

Prevention    Return to top

Avoid contact with contaminated water. Wear gloves or wash thoroughly when cleaning aquariums.

References    Return to top

Holland S. The nontuberculous mycobacteria. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 346.

Update Date: 3/17/2009

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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