Jim Bertch is a founding member of MTOA and has been around boats all his life. If you handle boat lines or clean fish tanks, please heed the caution Jim gives below. This all sounds just plain scary!

Update 7/4/13
Fifth surgery Tuesday 7/2. The infection continues to erode the bones in my hand and even though I have been on a strong anti-biotic regimen for a year the doctors are prescribing a new anti-biotic this week.
This continues to be a terrible, insidious infection so protect yourselves accordingly. Make sure you clean and disinfect ANY wound you have if you have been exposed to wet lines or wash down water. The bacteria will enter through a pin prick or an abrasion. I got the infection in the Chesapeake but it is becoming prevalent throughout the East Coast. So far, I know of incidents in MD, VA, NC, SC and Florida and I am sure there are others that I have not heard of.
Take care!
Jim Bertch
And this from Wikipedia:
Mycobacterium marinum is a free-living bacterium, which causes opportunistic infections in humans. M. marinum sometimes causes a rare disease known as aquarium granuloma, which typically affects individuals who work with fish or keep home aquariums.
Wikipedia

My husband had this infection last winter. It wasn’t easy to diagnose because it’s very difficult to get a culture. He had surgery in Savannah and again in Vero Beach when it still wasn’t healed. In hindsight, I don’t think the infectious disease doctor in Savannah was on the ball. If she had treated him with the correct anti-biotic, it may have healed faster. He spent a week in the hospital on IV anti-biotics. The doctors in Vero Beach were familiar with this type of infection and recognized it right away.
It didn’t manifest itself as what you typically expect with an infection. There weren’t any red streaks. His hand was just swollen and red. It’s good that you published your story. Everyone on a boat should be aware of this infection and get treatment right away!
Harriet

As a cruiser, often days away from medical interventions, I read this note with interest. I am still in the dark about what type(s) of antibiotics were or could be successful treatment for this rather nasty infection. As with siguatera, forewarned is definitely forearmed. Quick action, a reality dose of prevention and having the proper medication handy is always called for. Some of us would call this being medically prudent.
cap’n denny

Jim
I am most curious as to how does this manifest itself ‘“ a wound that does not heal or something that looks like a spider bite that heals very slowly or not at all etc.
Obviously I have a reason for asking as I have a spot on my hand that looked like a spider bite- went to bed with no mark and woke up with an area on my index finger joint that was red and swollen. That was at least 4 weeks ago and it is still `trying’ heal with the Sulfa anti ‘“ biotic that I have been taking.
Again, really interested in how it manifested itself on you.
Thank you
Pat Kenefick
S/V Cynthia Gale

The two cases that I’m familiar with resulted is such severe swelling that the skin literally burst. One was below the knee, one was a hand. In each case the swelling `stopped’ at the joint (knee and elbow). The second case was treated promptly by an MD in Reedville VA, at mouth of Potomac with good results. The other case lingered terribly, and I have lost track of the person so I do not know if it was successfully treated.
Trina

My husband originally cut his knuckle on a hose clamp (rebuilding the head, of course!). The cut took a long time to heal because he kept hitting it on things. The infection started as a red spot on his palm about 3 weeks after the original cut. His middle finger became swollen and painful. The first hand surgeon treated his with IV antibiotics and also reopened the original cut and removed some small pieces of metal that didn’t show up on the X-ray or MRI. We thought that was the end of it. After the swelling returned the second hand surgeon opened and drained the swollen finger. The infectious disease dr treated him with Clarithromycin (500mg) and Doxycycline Hyclate (100mg). What an ordeal! So glad it’s finally healed (except for some slight stiffness.). This took place over 4 months so we never made it to the Bahamas last winter. This experience made us realize what a challenge it is to get medical care while cruising. His first visit to urgent care was a place that didn’t file insurance claims so we paid out of pocket. Still waiting for Medicare to reimburse but not hopeful. Our only other recourse was an ER visit in Savannah on the day after Thanksgiving. What a nightmare! At least the hand surgeon they called in was excellent. The medical care in Vero Beach was excellent too once we got a referral from urgent care.
Harriet

Hello,
I have had an interesting experience with bacterium marinum In 2009 my wife and I bought Grace, a 34 ft Gemini Catamaran, and sailed away into the sunset from Brunswick,Georgia too the Keys. It was on November 11th, Veterans Day that I was cleaning the hull, and cut my middle finger on a live oyster shell. In December, just after Christmas, my finger became swollen. A visit to the emergency room and I began the first of many visits to many doctors. No one could figure out what it was’¦I was in Maine. First it was visits to be treated for gout, then the wrong antibiotics, while my hand became swollen, and my arm, up to my elbow. A culture showed up as an `acid fast’ bacterium. Finally one infectious disease doctor diagonosed `bacterium marinum’. It was now March, and surgery was required to save my hand. And 6 months of 3 different antibiotics. The surgery scraped my tendons, too clean as much infection as possible. I have lost much of the use of my right hand, but the infection finally was removed. Also while being treated for the infection, it was discovered that I had kidney cancer. This was removed, and no more kidney or cancer. I am positive that the bacterium marinum led to the cancer discovery, as I almost never get sick or visit a doctor, which saved my life.
My second experience with bacterium marimum is still underway. I have had two tissue clutures, and nothing positive yet. I was changing an engine mount, and cut my knuckle in January. Same symptoms, swollen finger, (different hand), swollen elbow, arm, but the cultures are very very slow to show results. So I have been mega-dosing with liposomal Vitamin C, with some positive results. The swelling in my arm and elbow is gone, and my finger and knuckle are almost normal. It has cleared up a nasty sinus infection that I had for a month in just a few days.
Jim Duhamel

This infection was brought to my attention by another member of our yacht club, who included the address of a very medically informative article, as follows:
http://cid.oxfordjournals.org/content/31/2/439.full
Pete Schulz sv Selamat Jalan