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Fish tank granuloma

This is due to a mycobacteria called mycobacterium marinum.  This is seen in fish handlers and rarely as a result of swimming in fresh or salt water.

Patients present with a small nodule either on the hands or feet.  There may be small nodules spreading upwards in a linear pattern.

A skin biopsy will be done and culture may be done for mycobacteria.

Treatment

Antibiotics – minocycline

Local heat application by thermal water bottles is a useful adjunct in treatment. 

 Treatment with antibiotics should be carried out for more than two months or more.

even though the links below refer to images of foreign body granuloma they look the same