Clinical manifestation

Occurs most commonly in people that work in rural areas where they are exposed to acacia trees or cactus thorns containing the etiologic agents; slow-growing, painless, suppurative papules and nodules, abscesses and fistulae drain clear, viscous, or purulent exudate or grains; affects upper and lower limbs, particularly the feet and lower legs; progressive extension and formation of multiple sinus tracts; extensive tissue swelling, induration, and destruction; chronic lesions contain healed, scarred, sometimes closed sinus tracts with new, open, suppurative tracts in other adjacent areas; invasion of bone cortex results in replacement of osseous tissues and marrow by masses of grains

400 Mycobacterium marinum infection

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