• Bo Sang, Xiujiao Xia, and Zehu Liu.
• Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
• Medicine (Baltimore). 2024 Oct 18; 103 (42): e40179e40179.

RationaleMycobacterium marinum (M marinum), a slow-growing nontuberculous mycobacterium (NTM), is widely distributed in aquatic environments. It is a well-known cutaneous pathogen, which causes sporotrichosis-like lesions.Patient ConcernsIn this report, we describe 2 cases of subcutaneous M marinum infection. Both patients underwent several surgical procedures at local hospitals, and despite optimal surgical site healing, new lesions appeared in adjacent sites.DiagnosesBased on NTM culture, identification by gene sequencing, and matrix-assisted laser desorption ionization time-of-flight mass spectrometry, the diagnosis of subcutaneous NTM infection was confirmed.InterventionsThe patients were treated with oral rifampicin 0.45 g/day and clarithromycin 1 g/day and oral doxycycline hydrochloride capsules (200 mg/day), respectively.OutcomesBoth patients were treated for 8 and 5 weeks, respectively, and the lesions healed.LessonsSurgical debridement cannot compete with or impede NTM lymphatic spread; antimicrobial therapy is the first choice for the treatment of M marinum infections.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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