AFB

Fish tank/swimming pool granuloma

Due to Mycobacterium marinum, which causes a localised papular or

nodular skin lesion, usually in people who clean aquaria or swimming

pools. Diagnosis is by biopsy and culture (acid-fast bacilli).

Treatment: single lesion excision (may suffice). May need antibiotic

therapy e.g. clarithromycin (o) bd for 3–4 months plus rifampicin for

severe or unresponsive infection. Seek expert advice.