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Emergency Medicine Journal 2006;23:e47; doi:10.1136/emj.2006.036004
© 2006 BMJ Publishing Group Ltd and the College of Emergency Medicine.

EMERGENCY CASEBOOK

Case report of non-healing wounds presenting to a DGH, South East London

A Umrawsingh, A Huggon

Emergency Department, Queen Elizabeth Hospital, Woolwich, London, UK

Correspondence to:
Correspondence to:
Dr A Umrawsingh
Flat 11, Ritter Street, London, SE18 4DT, UK; ashaumrawsingh{at}yahoo.co.uk

ABSTRACT

Mycobacterium marinum infections (fish tank granuloma) are infrequently encountered and when they do arise, they can pose a diagnostic challenge for clinicians. They can present as non-healing wounds along with several other presentations that may not be typical, as patients can have other comorbidities that cause immunosuppression and invasive symptoms of the disease. Treatment regimens vary in length, and are based on the patient’s response to treatment couple with resolution of symptoms. Rifampicin and ethambutol are effective treatment options, together with use of macrolides. A thorough history from patients must be taken as to establish contact with aquatic animals.

Abbreviations: ED, emergency department

Keywords: Fish tank; granuloma; mycobacterium; non-healing; wounds


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