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Re: TB, Minocycline & Erythromycin

> Date: Wed, 18 Jun 1997 01:42:54 -0700 (PDT)
> From: "A. Inniss" <andrewi at u_washington.edu>
> Subject: TB, Minocycline & Erythromycin
> > I really doubt that any type of tuberculosis infection can be treated
> > with a few days of those products
> 	Agreed!
> >Since there might be a risk of transmission to humans,
> 	Well, I'm a little (okay, way ;-)) behind on the latest research,
> but last I knew, it appeared M. fortuitum wasn't transmittable from fish 
> to human...

I did a quick Medline search, and found 32 articles since 1993 about
human mycobacterial infections caused by M.marinum.  Most of these
were skin lesions, but some involved joints and tendons.  Apparently
"swimming pool granuloma" and "fish tank granuloma" are well-known 
syndromes caused by M.marinum.  Some skin lesions required surgical
excision before they would heal.

From what I could gather from the abstracts, most of these people had
normal immune systems, but some were mentioned to have had minor skin
injuries (abrasions and scratches) at the time of infection.

This isn't just some weird third world disease - most of the reports
were from North America and Europe.

It's probably a good idea to wash your hands and arms with soap after
messing around in the tank...  I'm going to try to remember to do so.

> >TB infected fish should be immediately destroyed rather than fussing
> around with attempts to medicate.
> 	Well, it certainly is tough to beat with meds, so it may not be
> worth the money and effort.

I also ran into the following abstract.  It looks like the standard human
drug against atypical mycobacterial infections isn't very useful in fish.

    Boos S.  Schmidt H.  Ritter G.  Manz D.                                 
    Staatliches Medizinal-, Lebensmittel- und Veterinaruntersuchungsamt   
    Mittelhessen, Giessen.                                               
    [Effectiveness of oral rifampicin against mycobacteriosis in tropical
    fish]. [German]                                                     
   Original Title                                                      
    Untersuchungen zur oralen Wirksamkeit von Rifampicin gegen die
    Mykobakteriose der Zierfische.
    Berliner und Munchener Tierarztliche Wochenschrift.  108(7):253-5, 1995
    In vitro studies have shown that rifampicin is an effective antibiotic for
    mycobacteria infections. Two species of tropical fish, the Firemouth
    Cichild Cichlasoma meeki and the Congo Tetra Phenacogrammus interruptus,  
    were used to determine whether oral application of rifampicin might serve
    as an effective treatment for mycobacteriosis in tropical fish. Fish of   
    the two species were infected with M. marinum under controlled conditions
    Six or twelve weeks after infection, treatment was begun with medicated   
    fish food containing rifampicin in combination with tetracyclin.
    Histological examination of epithelial cell granuloma in the anterior and 
    posterior kidneys, as well as in liver and spleen, showed that antibiotic
    treatment could somewhat reduce the intensity of, but could not           
    successfully eliminate infection. In addition, after treatment,
    acid-resistant rods could still be isolated from histological samples and 
    M. marinum could be cultured from organ samples.

From other articles I gather that there are numerous other species of
mycobacterium that cause disease in fish and can be acquired by humans.
Btw, if any of you ever have a positive TB test, mention that you may
have been exposed to some of these species, and a more sensitive test
can be done to determine whether you have been exposed to human TB.