Necrotizing Soft Tissue Infection Occurring after Exposure to Mycobacterium marinum

Figure 4

Persistent necrotizing soft tissue infection resulting in a ray amputation. Approximately one month following the second surgery, he presented to clinic with persistent swelling, erythema, induration, and dark necrotic appearing tissue along the base of the affected finger, consistent with persistent necrotizing soft tissue infection secondary to mycobacterial involvement. Ray amputation of the right ring finger was performed, and tissue pathology was consistent with granulomatous inflammation and necrosis, indicating a necrotizing soft tissue infection. Oral moxifloxacin and clarithromycin were continued to complete 6 months of therapy. During this time, he had marked clinical improvement and no evidence of persistent necrotizing soft tissue infection.