Some Infection Details of Aquatic/Fish Tank Infections
by Adrian Lawler, Ph.D.
(retired) Aquarium Supervisor (l984-l998) J. L. Scott Aquarium Biloxi, Ms 39530
Aquarticles
Since the posting of my talk in l997, various people have contacted me concerning their
water-borne infections. As details of the methods of infection may benefit the reader, I
have summarized some of the cases reported to me and presented them herein. Names, and
cities, of people infected are not included to protect privacy. For brevity, each type of
disease is listed, then the infection methods of some of the cases are presented.
Treatment methods and final outcomes are not included for each case. People suspecting
an infection should consult their own medical doctors for diagnosis and treatment. In Tank Safety/Fish TB, (as posted on Aquarticles),
I list steps to follow to seek a cure of an infection.
Mycobacterium marinum (either diagnosed or strongly suspected):
1….Female got pinched on right index finger by a blue crab. Infection resulted in
pinch site that did not bleed. Lump formed at pinch site. It took a long time to diagnose
correctly and infection had become more intense, so it took long time, over a year, to
cure.
2….Male public aquarium worker was stuck by sheepshead spine on right small
finger. Within 2 weeks finger had become swollen, felt hard, and was dark purple in color.
A sample was cultured, M. marinum was diagnosed; infection was cured in 6 months.
3….Male was stuck in left middle finger by fin spine of hybrid striped bass in an
aquaculture facility. Shortly after being stuck, the finger became swollen and pink with a
3-inch pink streak going toward palm of hand, and an open wound at site of infection.
After initial cure, the worker was infected twice more at facility, once by a splinter
from handle of fish net.
4….A middle-aged female cut her finger on a glass rock while cleaning her fish
tank. After cleaning the tank she cleaned a pump in an outdoor pond. She developed a
finger infection, swollen and red to purple in color, that also led to a swollen arm lymph
node. It is not known if she got infected from the tank or the pond.
5….A middle-aged man fell in muddy water at low tide, scraping his outer calve on
a houseboat barge which had barnacles attached to it. His leg became infected and after
numerous surgeries they diagnosed him as having Mycobacterium marinum or fish
tank granuloma. He was in the hospital for over 10 days with not much improvement and had
surgeries to release fluid build up on his knee, along with a drainage tube that was
inserted into his calve. They also removed some tissue from his leg. Recovery took a long
time.
6….Woman slipped and fell from a dock, cutting her hands on oyster beds. Without
benefit of x-rays, the ER attendant sewed shell fragments up in the thumb and middle
finger on right hand which were then embedded for nearly 30 days before two corrective
surgeries were done. Antibiotics (with sickening side effects) were taken for over 9
months.
7….Man had a freshwater fish die from, apparently, fish TB. At the time of fish
death, fish was isolated in its own tank. About the same time, man developed bumps on his
hand and fingers, which had an open wound at the same time. These bumps were biopsied at a
dermatologist's and the diagnosis of M. marinum was confirmed. He took an
antibiotic and the bumps (granulomas) began dissipating; his doctor told him the bumps
would dissipate on their own but that it could take upwards of a year.
8….Man got pinched by blue crab, and infection developed; Mycobacterium
marinum was diagnosed. After two surgeries and two months on three antibiotics,
infection decreased. Third surgery was done to cut adhesions of tendons to flesh of palm
and to clean out foci of infections.
9….Man in water offshore cut foot in several places on barnacles. Wounds were not
healing after two months; and he was attended by two doctors who gave different
antibiotics that did not work. His big toe was dark purple including a black toe nail. The
toe changed colors - one day it was all black, next day it was dark purple, then black
again. Long bout to healing.
10….Woman who was diabetic fell and cut her arm. The sore (at cut) got very large
and open and pus- filled. It would not heal. She was taking antibiotics and started
getting more sores around the original one. After seeing many doctors relatives took her
to an infectious disease specialist. He told her he thought that she had a bacteria from
her fish. She has a betta fish in her home and may have cleaned the bowl the day before
she cut her arm. The sores were purple, some bigger than others and were pus filled.
NOTE:
1….Mycobacterium marinum might have survived on her arm for one day prior to
her getting cut.
2….Diabetes leads to poor circulation, and lower temperature of an extremity, thus
fish TB can easier spread in those with diabetes. People with diabetes also have a
weakened immune system and would be more prone to infections.
Mycobacterium chelonae
1….A female (in her 30's) undergoing breast surgery was infected with Mycobacterium
chelonae, apparently either while undergoing surgery or bathing after surgery, via
infective bacteria being in the tap water. M. chelonae is usually found in soil
and water and gets into public water reservoirs. Improperly treated water is then
delivered to homes, hospitals, etc, where people can get infected. Numerous surgeries and
various antibiotics did not cure the infection. Patient finally had infected breasts
removed and reconstructive surgery begun.
Vibrio spp. (diagnosed or strongly suspected):
1….Vibrio parahaemolyticus infection is usually associated with ingestion
of raw shellfish, recently there was a case locally where a man got arm infection while
using a cast net. He almost lost his arm and life.
2….Vibrio parahaemolyticus infected the captain of fishing charter boat
via his handling of fish. Took massive doses of antibiotics to cure.
3….Woman working in a shrimp culture facility got stuck by shrimp spines.
Infection from Vibrio resulted; took several months to cure.
Herpetic whitlow:
1….A woman working in a seafood store got stuck while thawing shrimp 13 years ago.
After much trouble with her hands, including the development of severe arthritis-like
conditions, she was guessed at having M. marinum infections by some doctors, and
herpetic whitlow by another. No causative agent has yet been isolated. Her problems
continue.
Unknown infection:
1….A male freshwater marina worker was picking up trash along the water's edge of
a lake. He did not wash his hands prior to going to rest room. Subsequently, he developed
an external infection of the penis. It is suspected that boats were dumping raw sewerage
into the lake, maybe even at the marina, and he picked up a human STD or other disease
from the sewerage water on the trash he picked up.
2….Several years ago, while scraping the bottom of his boat, a man got infected
after a small piece of the wire from the brush became lodged in the knuckle joint of one
of his fingers. Symptoms were: pain in the joint radiating up his arm, a popcorn
kernel-like covering spreading out from the center of the joint, and a symmetrical web of
something like 5-o'clock shadow which pushed up through the surrounding tissue. Unknown
cause.
3….A male got a bad eye infection after swimming in waters off a resort area. He
had bilateral eye swelling, redness, soreness, thick opaque mucous discharge, and severe
tearing. Infection was presumed to be due to his swimming in sewerage pollution.
4….Girl swam with the dolphins and sea lions at a facility; shortly thereafter she
came down with a mysterious malady. Initially it was an infected eye, then a swollen head
and pain. Apparently the infection entered via eye or tear ducts. Infection was presumed
to be due to her swimming in animal sewerage pollution that was not handled by the
filtration system at the facility.
5….Female siphoned a fish tank and ingested part of the foul water. She later
developed a bad sore throat and tried to relate it back to tank. Unknown cause.
6….Female caught fish out of a polluted canal, and ended up with rash on left hand
(which held fish to remove hook) and going up arm. Small round ulcers just under skin,
sometimes raised welts, and itch. Had for over 3 years. Unknown cause.
7….Female working with shedding blue crabs. Her symptoms started with a rash on
the back of head. Sores the size of a quarter erupted on her neck and went down her arms,
buttocks, legs, and feet. Had 2.5 years, has seen nine doctors, and no diagnosis yet.
8….Man appeared to have developed an allergy to salt/sea water which started after
he stepped on a piece of dead coral after visiting a tropical beach. It was a deep scratch
which was more painful than the injury looked. The next time he swam in the sea was about
one week later at another tropical beach, and he had small lumps on his legs, which were
not irritating and went away after about an hour. The second time it was worse in his
friend's salt water swimming pool, his hands swelled up after the palms felt itchy and his
whole body was covered in the small lumps and he had a slight headache and didn't feel
well. The third time he was just paddling about in tropical waters and he could feel his
hands swelling and itching coupled with lumps on the legs.. Since his return to home he
has seen a doctor and a blood test has confirmed that his antibodies are significantly
raised. Doctor has suggested to avoid swimming in the sea and to take antihistamine
tablets should he get this reaction again. Unknown cause.
Follow suggestions noted in Tank Safety/Fish TB
to avoid aquatic or tank infections. Also, with increasing human populations and
improper sewerage treatment, it is dangerous to swim in many areas of the world,
especially after rains that cause sewerage system overflows.
ADDENDUM
July 2004. Environmental News Service provided the following:
Texas Man Loses Both Legs to Bacteria
HOUSTON, Texas, July 29, 2004 (ENS) - Fun in the sun turned into a nightmare for two
Houston men this week. One man had both his legs amputated and the other is in intensive
care after they picked up a bacterial infection while fishing in Port O'Connor Bay on the
Gulf of Mexico.
The Houston Chronicle reports that the men were infected with the vibrio vulnificus
bacteria when they waded into the water with their fishing gear.
They had open cuts through which the bacteria entered, said a spokesperson for Citizens
Medical Center in Victoria who declined to release the victims' names at their families'
request.
In a separate incident, a Bay City fishing boat captain is in stable condition at
Matagorda General Hospital in Bay City with what his doctors suspect is the same bacteria.
The vibrio vulnificus bacterium has been isolated from water, sediment, and plankton as
well as oysters, clams and crabs located in the Gulf of Mexico, the Atlantic Coast as far
north as Cape Cod and the entire U.S. West Coast. Cases of illness have also been
associated with brackish lakes in New Mexico and Oklahoma.
Vibrio vulnificus is also found in raw oysters and shellfish and can cause illness or
death if the shellfish is not cooked enough.
The presence of vibrio vulnificus is not associated with pollution. The bacteria is a
naturally occurring marine organism that thrives in shallow, coastal waters in temperate
climates throughout most of the world, according to the Florida Department of Health and
Rehabilitative Services.
The Centers for Disease Control (CDC) states that an average of 50 culture-confirmed
cases, 45 hospitalizations, and 16 deaths are reported each year from the Gulf Coast
region - Alabama, Florida, Louisiana, Mississippi, and Texas.
Nationwide, there are as many as 95 cases - half of which are culture confirmed - 85
hospitalizations, and 35 deaths, the CDC reports.
Infections are seasonal. Over 85 percent occur between May and October. According to
the CDC, environmental factors, such as warm water and moderate salinity, can increase the
number of vibrio vulnificus organisms in shellfish.
The vibrio vulnificus infection is fatal in 50 percent of cases after it enters the
bloodstream, experts say.
|