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FAQs about Pet-fishing & Human Health: Bacterial Infections
Related Articles: Wounds Articles, Moray
Eels Bite, But Are They Venomous? by Marco Lichtenberger,
Related FAQs: Petfishing and Human Health 1, Petfish
& Health 2, Petfishing & Human Health 3,
& FAQs on: Petfishing Concerns: Getting
Poked, Spined, Stuck, Envenomized
(injected), Bitten,
Poisoning (ingesting), Skin et al.
Contact, Companion Animal Involvement,
Troubleshooting/Fixing, Parasitic Cross
Zoonoses, Turn About's Fair Play...
Stingrays, | 
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Sick Goldfish ... RMF's go 7/28/06
I would like to ask you a question about my goldfish. She is losing
her orange color, having difficulty getting up to the surface of the
water, and when she does make it up (with great effort) she gulps
air and then descends again.
She spends most of her
time just laying on the bottom of the tank, and she is listing to
one side.
<All bad signs>
While searching the Web for
answers I read about fish tuberculosis. My fish seems to have many
of the symptoms. This concerns me (because I don't know if it is or
isn't, and I don't know what to do for the fish) and also because it
said that this disease is transferable to humans.
<Yes>
While I washed my hands afterwards, I did clean out the
tank by hand, stirring up the gravel, washing off the
rock, etc.
<Unless there are breaks in your skin...>
My cat
also drank from the fish tank while I was transferring the fish to
a bowl. Should I be concerned about the possibility of TB, how
could I know for sure if this is what my fish has, and what can be
done for the fish?
<Not able to tell from here... however
Mycobacterial transference is not likely>
If it is not TB, then
I thought it could be a swim bladder problem (my fish does have
trouble with constipation), but why is she losing her color?
<Could be several influences>
Thank you for listening to my
question. Any help you could give me is most appreciated.
<Have
you read here:
http://wetwebmedia.com/FWSubWebIndex/gldfshdisease.htm
and
the linked files above? BobF>
Sick Goldfish ... Tom's much better go 7/28/06
<<Greetings. Tom here today.>>
I would like to ask you a
question about my goldfish.
<<Fire away.>>
She is losing her
orange color, having difficulty getting up to the surface of the
water, and when she does make it up (with great effort) she gulps
air and then descends again. She spends most of her time just laying
on the bottom of the tank, and she is listing to one side.
<<Not good, certainly, but having "peeked" at the remainder of your
post, I've noticed that you haven't included any of the very
important information that would be useful here. What "type" of
Goldfish, tank size, type of filtration, water parameters
(critical!), diet, etc. From our perspective, it's like asking us
why you just sneezed. A cold? Hay fever? Allergies? Someone tickled
your nose with a feather? Sounds a bit silly but I think you see
what I mean. Fish can display very similar symptoms from a wide
variety of causes.>>
While searching the Web for answers I read
about fish tuberculosis. My fish seems to have many of the
symptoms. This concerns me (because I don't know if it is or,
isn't, and I don't know what to do for the fish) and also because it
said that this disease is transferable to humans.
<<Possible?
Yes. Likely? No. I understand your concern but I would suggest that
it's not warranted. What you've described thus far could simply be
due to your pet being in too small of an aquarium or living in water
conditions that are sub-par. At this point, I really don't know.>>
While I washed my hands afterwards, I did clean out the tank by
hand, stirring up the gravel, washing off the rock, etc. My cat also
drank from the fish tank while I was transferring the fish to a
bowl. Should I be concerned about the possibility of TB, how could
I know for sure if this is what my fish has TB, and what can be done
for the fish?
<<I think you should be "aware", as we
all should be. Concerned? No. To know for certain would require a
laboratory and a pathologist. A couple of indicators would be a
sunken stomach or detention (sinking) along the back of the fish.
Protruded eyes, loss of scales, lesions on the body of the fish
would also be indicative but not definitive. As for what can be done
for the fish in the case of TB, there are some treatments that would
likely be out of the realm of the typical hobbyist. In all
likelihood, the animal couldn't be treated effectively.>>
If it
is not TB, then I thought it could be a swim bladder problem (my
fish does have trouble with constipation), but why is she losing her
color?
<<Here, we go back to my earlier comments.
Goldfish, regardless of their opportunistic feeding habits, require
lots of vegetation in their diets. They don't process proteins well
and become "compacted" when fed a diet that is too high in these.
Much information on our site about the appropriate diet for Goldfish
as well as the environment that they require to thrive.>>
Thank
you for listening to my question.
<<Not a problem at all.>>
Any help you could give me is most appreciated.
<<If you
wouldn't mind, I'd like you to give me your name when you post
again. Tom>> Re:
Sick Goldfish 7/28/06
Thank you for your reply, Tom.
<<Good to talk to you again,
Debra.>>
I do not know the technical name for the Goldfish--she
is orange in color, having a regular, slim, not a "fancy" body
type, with a black dot on her tail (which has always been there).
<<What you have is either a Common Goldfish or a Comet Goldfish.
Both are very similar with the Comet staying a bit slimmer than the
Common as it matures. Both can attain 12"-14" in length at
adulthood. (Can't blame you if you just did a "double-take".)>>
She is now about 2.5 inches long from mouth to tail tip. She is in a
two gallon tank.
<<Way too small but I'll get back to this as we
go on.>>
It used to have an air stone, but I put a charcoal and
"sponge type" filter in the tank when I found out that it would do a
better job of filtering out the ammonia in the tank.
<<Good...with a proviso. While the airstone will do nothing for the
ammonia, it does agitate the surface water of the tank and helps in
oxygen exchange. This is where your Goldfish is getting its air to
breathe. The larger the surface area, the more oxygen that enters
the tank. The fact that she's gulping air indicates that she isn't
getting enough oxygen from the water. (Small piece of "trivia": A
fish's gills are much more efficient in extracting oxygen from water
than our lungs are in extracting it from the air. We can "afford"
this inefficiency because oxygen is so plentiful in our environment
compared to a fish's. I add this for emphasis as well as a bit of
extra information.) Side note: activated carbon is effective for no
more than 3-4 weeks.>>
I changed 80% of her water about every
1-2 weeks, with periodic full tank water changes. When she got sick,
I did a full tank change
and rinsed her rock, gravel, sides of
the tank, and plastic ornamental plants as I do periodically.
<<When ammonia/nitrites are an issue, this amount is likely
appropriate but, for now, I'd prefer to see you change out 15%-20%
once a week. This presupposes that your ammonia/nitrite levels are
at 0 and nitrates are below 20. A fish store can test a sample of
your water for you if you don't have a test kit...which I would
highly recommend getting.>>
Previously, I was using regular
filtered tap water for the water changes with several drops of
"stress coat" to condition the water,
but when she got sick, and
I consulted a pet shop, they recommended that I use bottled water,
which I did (I still added a couple of drops of Stress Coat, too).
<<Neither "filtered" tap water nor bottled water are the best
choices here. Filtering water removes elements that fish need,
so-called "trace elements" though major and minor elements would be
involved, as well. We almost always recommend that you acclimate
your fish to whatever source of water you have at the tap - without
filtering. Adding a good quality dechlorinator - one that eliminates
chlorine and chloramine - is all you need to do. (Chloramine is a
combination of chlorine and ammonia, used in increasing numbers of
areas because chlorine alone dissipates so quickly. Chloramine does
not. Stress Coat TM) only removes chlorine, by the way. If your
source of water is treated with chloramine, you'd be introducing
ammonia to the tank.>>
I called my cat's Vet but was told that
they don't see fish.
<<About what you'd expect from a "cat
doctor". :)>>
They gave me the number for a fish Vet at U of P.
I left several messages, but no one called back yet. I was told the
Dr. was only in intermittently--so I turned to the Internet, and
your postings for help.
<<Along with your commitment
to your pet, we might just get this turned around.>>
My Goldfish
was very healthy prior to last week (except for the chronic
constipation--I did try the peas in the past, but it seemed to only
help a little-). She is still hanging on at the bottom of the tank,
but is staying in one spot and if I put food in, she will struggle
to rise to the surface, but she mainly gulps a lot of air when she
is up there.
I don't know the chemical status of
the water, but I just changed it all with the bottled water, so I
don't think there is an ammonia
build up.
<<Goldfish excrete ammonia through their gills just like we exhale
CO2. Regardless of the lack of fish waste/detritus in the tank,
ammonia is going into the water. Back to what I mentioned about
aquarium size now, your Goldfish needs to be in, at least, a
30-gallon tank. Commons and Comets are generally considered to be
"pond fish" because of their adult sizes. Unless kept in a
sufficiently large indoor tank, you'll ultimately run into one
problem after another. Growth will be slowed/stunted leading to
health problems like bone disease. Most importantly, despite your
best efforts, a two-gallon tank can't dilute the toxins in the water
adequately to provide a high-quality environment for your fish. Any
measurable amount of ammonia in the tank will cause the gill
membranes to swell/thicken (basically being chemically burned) to
the point that your fish will start to suffocate. The "immediate"
thing to do now is put the airstone back into the tank and turn that
"bad boy" up high! And, start making plans to get a much larger
aquarium...>>
She is very pale. When she is at the bottom, she
lists to one side a bit. She does not look particularly emaciated,
though. In fact, she looks fat like she is still constipated--and
there are no visible lumps, bumps,
discolorations or
spots (other than the one that she was born with), her eyes are not
abnormal. She definitely has some sort of equilibrium issue, but she
doesn't really fit nicely into any one disease category.
<<All typical of water quality issues with the possible exception of
the constipation.>>
When I first got her, I fed her the small
pellet type food. When even the small pellets looked too large and
hard (I would crush them a bit) I tried the flake food, but I think
she prefers the pellets, so when she got sick, I switched back to
the pellets).
<<She needs vegetable matter in her diet, Debra.
Goldfish don't process proteins at all well. Zucchini, spinach,
shelled peas (which you've tried) among other common veggies are all
good for her and will keep her "cleaned out". Brine shrimp also act
as a laxative because of their "roughage". Also, do a search on our
site regarding Epsom salts. Many folks have good success with a
treatment of these.>>
I hope this gives you more information,
although I know it must be difficult to diagnose a fish sight
unseen. Thank you for your time and any help you can give.
<<I've probably given you more than you necessarily wanted here,
Debra, but I've hit what I believe are the key points. Bigger tank,
more filtration, aeration and diet. A little overwhelming, perhaps,
but this is what your pet needs.>>
Sincerely,
Debra
<<My
best to you and your Goldfish. Tom>>
Re: Sick Goldfish 7/28/06
Dear Bob F.,
Thank you for your prompt reply. I did peruse the
site you listed plus many others, but my fish did not fit nicely
into any of the disease categories, so I was still puzzled. I will
copy Tom's email to me and my reply to Tom's email FYI.
<I see
(place) all>
I hope that this information will shed more light
on the matter, and that the problem may have a solution. And yes,
my hands did have breaks in the skin from playing with my cat who
accidentally scratched me, and from torn cuticles, that was why I
was concerned.
<... might be worth a visit to a medical center
if you are indeed concerned>
I also quarantined my fish in a
large glass salad bowl while I was changing the water in her
tank--I bleached out the salad bowl and washed it with
antibacterial soap --along with my improvised "net", a slotted
kitchen spoon (we do not have a dishwasher) but now I wonder if I
should just discard the bowl and the slotted spoon I used to
transfer the fish with.
Sincerely,
Debra
<Mmm...
there are a myriad of degrees-of-infectious microbes in most
everyone's experience every day... I strongly suspect you have
nothing to fear here. I would not discard these implements. Bob
Fenner> |
Re: Lugol's Dip and Gorgonians, Pete, will you take a look at,
refer? & bacteria f', human dis. – 4/10/07
<Yowsa Pete!
Thanks as usual for this dissertation! BobF>
Dear Mark:
Bob
forwarded your email to me and asked me to lend a hand with
your dilemma. It's very difficult to say what may have caused the
demise of your H. kuda but I would be happy to share my thoughts on
the matter with you for whatever it's worth, sir.
Like all
fish, seahorses do occasionally develop various
granulomas, malignant neoplasms, tumors and fibrosarcomas associated
with certain diseases or the aging process, but these primarily
affect internal organs. Furthermore, such growths are not
characteristic of Vibriosis and, judging from the symptoms you
described -- or lack thereof -- it seems unlikely that a Vibrio
infection was involved in this case.
I am more concerned about
the possibility that the tumor may have been a granuloma symptomatic
of a Mycobacterial infection. Granuloma disease is caused by gram
positive, acid-fast bacteria from either the genus Mycobacteria or
the closely related genus Nocardia invading the tissue and internal
organs and organ systems. Both of these bacteria can affect the skin
as well as the internal organs, causing nodules and granuloma. And
both Mycobacteria and Nocardia can be transmitted to man, causing a
localized, unsightly skin rash after entering through a cut or
break in the skin.
Here is an excerpt from my new book (Complete
Guide to the Greater Seahorses in the Aquarium, TFH Publications,
unpublished) that discusses mycobacteriosis in more detail,
Mark. It may help give you a better idea whether or not the tumor
you noticed could have been associated with granuloma disease:
MYCOBACTERIOSIS, A.K.A. PISCINE TUBERCULOSIS
Mycobacteriosis
is also known by the following synonyms: fish tuberculosis, piscine
tuberculosis, granuloma disease, swimming pool granuloma, fish
tank granuloma, and acid-fast disease (Aukes, 2004; Leddo, 2002a).
Like all fishes, seahorses are susceptible to Mycobacteriosis. It is
not uncommon in wild-caught seahorses obtained from pet stores and
is the second most commonly seen bacterial infection of syngnathids
at large public aquaria after Vibriosis (Bull and Mitchell, 2002,
p20).
Cause:
Fish tuberculosis is caused by
pathogenic Mycobacteria, of which two different species are the
primary culprits: Mycobacterium marinum and Mycobacterium fortuitum
(Giwojna, Sep. 2003). Unlike most bacteria the plague fish, these
Mycobacteria are gram-positive, and take the form of
pleomorphic rods that are acid-fast and nonmotile (Aukes, 2004).
When cultured on solid media, they form cream-colored to yellowish
colonies (Aukes, 2004).
Mycobacteriosis is worldwide in
distribution (Giwojna, Sep. 2003). All fish species are considered
susceptible to it (Aukes, 2004). Although this disease can in fact
infect almost all fish, certain species are more vulnerable
than others (Giwojna, Sep. 2003). The most susceptible species are
freshwater tropicals such as black mollies, all Gouramis, Neons and
other tetras, all labyrinth air breathers, and most species of the
Carp family (goldfish and Koi, for example), Aukes, 2004.
Mycobacteria are ubiquitous and waterborne, and the aquatic
environment is considered the disease reservoir for fish
tuberculosis (Aukes, 2004).
Mycobacterium marinum has been
cultured throughout the world from swimming pools, beaches, natural
streams, estuaries, lakes, tropical fish tanks, city tap water and
well water (Aukes, 2004; Leddo, 2002a). Human epidemics
of granulomatous skin disease have occurred from swimming in
infected water, and in fact, this mode of human infection is far
more common than infection from exposure to infected fish tanks
(Aukes, 2004; Giwojna, Sep. 2003).
Clinical Signs:
There is a very severe or peracute form of this disease, in which
fish can simply be found dead without showing any telltale signs or
symptoms (Bull and Mitchell, 2002, p20), but that is quite rare. In
my experience, Mycobacteriosis is a chronic disease that progresses
quite slowly in aquarium fishes (Giwojna, Sep. 2003). It may take
years for an infected fish to develop any symptoms of apparent
illness and much longer before it becomes fatal (Aukes, 2004).
The glacial progression of the disease makes it difficult to
diagnose. Some early signs to look out for include lethargy, fin
loss, emaciation, skin inflammation and ulceration, edema, Popeye,
and peritonitis (Aukes, 2004). There may be superficial skin
lesions that take the form of small subdermal lumps or pus-filled
nodules of granulation tissue (Bull and Mitchell, 2002, p21).
These are simply the outward manifestations of a systemic infection
that may already involve many of the major internal organs (Bull
and Mitchell, 2002, p21). In later stages, nodules may develop in
muscles or skeletal structure and deform the fish. (Giwojna, Sep.
2003).
As difficult as slow-moving TB may be to diagnose while
the infected fish is alive, once the victim expires, postmortem
examination will reveal clear, unmistakable signs of Mycobacteriosis
(Giwojna, Sep. 2003). The telltale granulomas will appear as gray or
white nodules in the liver, kidney, heart and/or spleen (Aukes,
2004). There is often black, necrotic tissue eating away at the
internal organs, and there may also be skeletal deformities.
Diagnosis is then confirmed by the presence of acid fast bacteria in
tissue sections (Giwojna, Sep. 2003).
Treatment and Control:
There is no practical method for treating mycobacteriosis or
granuloma disease at the hobbyist level. As discussed below, good
aquarium management can prevent Mycobacteria/Nocardia from becoming
problematic. Prevention is the watchword for this condition.
Transmission:
The bacteria can be transmitted through the
water from open ulcers, through contaminated food (including live
foods such as shrimp or molly fry), via feces of infected fish, or
through the consumption of infected, dead or dying fish in the tank
(although the latter does not apply to seahorses), Aukes, 2004.
Contributing factors:
This disease is not highly contagious
and does not seem to spread from fish to fish readily (Aukes, 2004).
However, fish TB it is often associated with poorly kept or dirty
tanks with poor water quality (Aukes, 2004). Chronic stress from
factors such as overcrowding, malnutrition, or aggressive tankmates
often plays a role as well (Giwojna, Sep. 2003).
Mycobacterium,
the causative organism, is believed to be ubiquitously present,
making it very difficult to eliminate it entirely. However, if
good aquarium maintenance and management is followed, including
vacuuming of the gravel along with good filtration and regular
water changes, combined with a nutritious diet and the addition of
an enrichment product rich in vitamins, the problem can be minimized
and eliminated as a cause of mortality (Aukes, 2004).
Any dead
fish should quickly be removed and disposed of properly. Diseased
live fish should be isolated and treated in a hospital tank
(Giwojna, Sep. 2003).
Transmission to Man:
The
seahorse keeper should be aware that piscine tuberculosis is one of
the few forms of fish disease that is communicable to humans (Leddo,
2002a). This transmission usually manifests itself as an unsightly
skin rash involving one or more granulomas on the arms of the
fish-keeper (Leddo, 2002a). In severe cases, these nodules of
inflamed tissue can become large and disfiguring.
They
can spread and be very difficult to eliminate. The granulomas often
take some 2-4 weeks after exposure before manifesting themselves,
so the individual is frequently unaware of how he or she contracted
them and the condition very often goes undiagnosed (Giwojna, Sep.
2003). The Mycobacteria that cause the disease typically gain entry
through a break in the skin such as a cut, scrape, or abrasion on
the hand or arm of the aquarist (Leddo, 2002a). Although
unsightly, the granulomas themselves are not a serious problem and
are almost always localized and most certainly curable in healthy
individuals. But for those of us whose immune systems are
compromised by AIDS, kidney disease, diabetes, liver dysfunction,
chemotherapy or the like, the infection can sometimes
become systemic or, on rare occasions, even life threatening
(Giwojna, Sep. 2003).
Awareness is the appropriate response to
the risk posed by fish tuberculosis. The seahorse keeper should be
aware of the remote possibility of being exposed to Mycobacteria
via his aquarium, and take appropriate precautions, but there is
certainly no need to be overly concerned (Giwojna, Sep. 2003).
The aquarist should merely remain aware of Mycobacteria and follow
the usual sensible precautions. Nets, aquarium accessories and
equipment, and any other items that may come in contact with the
fish should be sterilized between uses to prevent
cross-contamination (Giwojna, Sep. 2003). Avoid mouth-siphoning of
the water in a Myco-positive tank (use a hand pump instead).
Mycobacterium cannot penetrate intact skin -- it only causes
infection after entering through open wounds or source, so make
full use of aquarium gloves and don't place your hands or arms in
the aquarium if you have any cuts or scrapes (Giwojna, Sep. 2003).
Handle sick fish carefully, dispose of deceased specimens properly,
and scrub up afterwards. Do NOT dispose of dead fish by flushing
them down the toilet, as this is a prime way to spread disease.
Place the fish carcass in a plastic bag or wrap it in some foil and
dispose of it with the solid waste of the household. And don't feed
dying fish to larger carnivorous fish, since this an excellent way
to spread infection (Giwojna, Sep. 2003).
One thing hobbyists
who are worried about fish TB can do to allay their concerns is to
get their seahorses and live foods (crustaceans such as shrimp are
known vectors for Mycobacteriosis) from a High Health facility such
as Ocean Rider rather than from their local fish store (Giwojna,
Sep. 2003). Seahorses at OR are routinely screened for pathogens
and parasites by independent examiners from an outside agency (DVMs
with the Department of Agriculture), and I know for a fact that
Mycobacteriosis is one of the diseases they specifically check
for (Giwojna, Sep. 2003). Thus far, multi-organ histopathology has
found no granulomas and tissue sections have revealed no acid-fast
bacteria -- conclusive proof that Ocean Riders are free of
Mycobacteria. <Close quote>
That's the rundown on
mycobacteriosis or granuloma disease, Mark.
The very similar
Nocardia is a gram positive, acid-fast, filamentous bacteria and is
even more insidious than Myco. Nocardia is closely related to the
Mycobacteria that cause piscine TB or granuloma disease and,
like Mycobacteria, it can affect the skin as well as the internal
organs, causing nodules, granulomas and pyogranulatomous cysts. And
like Mycobacteria, Nocardia can be transmitted to man, so be sure
to take appropriate precautions if you suspect granuloma disease
may have caused the death of your H. kuda.
Here is some
information from Paul Anderson explaining how professional aquarists
typically deal with Mycobacterium/Nocardia:
Fellow Seahorse
Enthusiasts:
Mycobacterium is a genus of bacteria that are
ubiquitous in almost all environments. Mycobacterium infections
occur in many (if not all) vertebrate taxa (e.g., mammals, birds,
fish, etc.). Some studies that have looked at prevalence of
infection of Mycobacterium in wild animals have often found that
a small percentage of wild animals are infected, even without
clinical signs.
The most common Mycobacterium species found in
seahorses are M. marinum, M. chelonae, and M. fortuitum. There is
currently no cure for mycobacterium infections in fish. The options
available are to 1) depopulate and disinfect the system, or 2)
maintain the fish but prevent cross-contamination by
observing strict biosecurity protocols. The second option is often
chosen by public aquaria with long-standing displays, when
aquaculture/production of the infected fish is not an issue.
Many mycobacterium spp. can cause disease in humans, especially if
the species is a rapidly growing one and/or if the person is
immunocompromised. Of the three species mentioned above, M. marinum
is a slow grower, and grows at 25 degrees Celsius incubation, but
not at 37 degrees Celsius. The other two are rapid-growing species
and grow at both temperatures of incubation. The significance of 37
degrees is that it is human body temperature. While most infections
of otherwise healthy people are limited to lesions on the
extremities (even with infection by a rapid-grower), there is a
greater risk of the rapid-growers to cause systemic disease
(especially in immunocompromised people).
In a Myco-positive
tank, the best option is not to come in contact with water or fish;
wear gloves (sleeved gloves if necessary). Avoid mouth
siphoning (use a hand pump). Having said that, in an aquarium
situation mycobacterium only causes infection if it enters a wound;
it cannot penetrate intact skin.
Effective disinfectants
against mycobacterium include spraying with 70% Ethanol and allowing
the equipment to air-dry, and bleach baths (I use 50ppm bleach baths
with a minimum contact time of one hour, this has been reported to
be effective against M. marinum) followed by sodium thiosulfate
neutralization baths. Ultraviolet light sterilization is also
recommended in Myco-positive systems. If you've got Myco-positive
tanks among other systems, common sense suggests performing
husbandry on these systems last in your rounds.
A note on
ethanol: I have found in my experience that seahorses are
very sensitive to ethanol, so I advise being very cautious to avoid
overspray into tanks (while we're€™re on the topic, has anybody else
observed this?)
Check out the following for more information
about mycobacterium infections in fish/aquaria:
<_http://edis.ifas.ufl.edu/VM055_
(http://edis.ifas.ufl.edu/VM055)
>
<_http://www.mdsg.umd.edu/Extension/finfish/FF9.html_
(http://www.mdsg.umd.edu/Extension/finfish/FF9.html)
>
Mainous, M.E., and S.A. Smith. 2005. Efficacy of common
disinfectants against Mycobacterium marinum. Journal of Aquatic
Animal Health 17: 284-288.
Paul Anderson
Ph.D. Candidate
Department of Fisheries and Aquatic Sciences
University of
Florida
That's the situation when Mycobacteria is confirmed in
an aquarium, Mark.
As long as you observe the proper
precautions and practice good aquarium management, it's a problem
the aquarist can sometimes live with...
Nocardia is a
different matter. When Nocardia is confirmed in an aquarium, the
only real recourse is to break down the entire aquarium,
discard the live rock, substrate, and invertebrates, sterilize
everything, and start over from scratch. The problem is that
Nocardia is saprophytic -- it doesn't require a host to survive and
it will persist in your system indefinitely. These bacteria live
off any kind of dead or decaying organic matter; in nature they are
commonly found in soil and wastewater -- in your tank, Mark, they
are no doubt entrenched in your substrate, live rock,
filters, everything -- where they act as a disease reservoir, ready
to infect any new fish and invertebrates (or careless humans) they
encounter when the opportunity presents itself.
The risk of
cross-contamination of your other tanks and specimens is
great, compounded by the fact that human health (primarily yours,
Mark) is also at risk from this organism. If your H. kuda was
infected with Nocardia, then everything in your 25-gallon aquarium
has been exposed to these bacteria and is potentially a source of
infection. Leading the tank lay fallow indefinitely will not help
with Nocardia whatsoever. If Nocardia killed your kuda, you must
consider all the equipment, decor and specimens in the tank to be
contaminated, Mark -- treat them like you would toxic waste or any
other biohazard.
Even your invertebrates are a risk. Your
coral, macroalgae, etc,. are all sources of organic matter, and can
therefore harbor Nocardia and carry the infection.
Do NOT
disperse your live rock, substratum, Gorgonia and soft
corals, macroalgae, equipment or accessories from the 25-gallon tank
to your other aquaria, Mark, or you will be inoculating them with
Nocardia and spreading the infection to all your tanks! And you must
be extremely careful to avoid accidentally cross-contaminating your
other tanks from your 25 gallon aquarium. Any nets, hydrometers, or
other equipment used in your 25-gallon aquarium should be
sterilized after every use and not placed into or used in any other
tanks.
Avoid working in infected aquarium with your bare hands,
scrub/disinfect your hands and arms thoroughly after working on the
tank, and do not place your hands in the 25-gallon tank and then
place your hands in another aquarium. These bacteria can even be
transferred from one aquarium to another by splashing
water droplets or as an aerosol via the mist generated from a
protein skimmer or an airstone. Be careful!
That is what I
typically advise hobbyists when Nocardia has been confirmed in their
aquaria, Mark. I hesitate to recommend such drastic measures
when Nocardia or Mycobacterium have not been confirmed. And the
tumor that you described is not typical of the pyogranulatomous
cysts that characterize Nocardia. They most often present as
greyish-white pimple like lesions on the skin.
They are often
motile when manipulated and may release a cheesy exudate when
compressed. That does not sound like the hard mass you detected
beneath the skin near the vent of the H. kuda.
So you're going
to need to use your own judgment, Mark. To be 100% safe, you could
discard the contents of your 25-gallon aquarium, sterilize
everything, and start over from scratch. Or you could dip the live
rock, Gorgonia, and corals with Lugol's solution as a precaution
and then trust to good aquarium management to keep the seahorses in
your 40-gallon aquarium healthy and happy. Since Mycobacteria and
Vibrio bacteria are virtually ubiquitous, and normally only become
problematic when the seahorses have been stressed and their immune
systems have been impaired, I might be inclined to take the latter
course in your case. If you can provide your seahorses with
optimal water quality, a nutritious diet, and they stress-free
environment, the chances are good that your livestock will not be
affected by granuloma disease or Vibriosis.
Starting out with
seahorses from a high-health aquaculture facility that you obtain
directly from the breeder will further increase your chances for
success. As an added precaution, you may also want to consider
installing an ultraviolet sterilizer on your 40-gallon
seahorse tank after it has cycled completely and the biofiltration
is well-established.
Best of luck with your new seahorse tank
no matter how you decide to proceed, Mark!
Respectfully,
Pete Giwojna, Ocean Rider Tech-Support Re: Lugol's Dip and
Gorgonians, Pete, will you take a look at, refer? – 4/10/07
Dear Bob:
<Pete!>
I'm always happy to help when I can, sir.
<And you do a fine job of it, I assure you>
When I receive
inquiries from aquarists regarding Mycobacteria/Nocardia, I feel it
is very important to provide them with as much information as
possible because of the possibility of human transmission and
because they may be confronted with the decision as to whether or
not it's necessary to depopulate their aquarium, sterilize
everything, and start over from scratch. So I make it a point to
try to arm them with all the facts they need to make an informed
decision in that regard.
<Yes... and one of the principal
reasons for my encouraging the publication of your book, your
articles (as well as others... including my own!) to get "complete
answers" to folks... in a speedily manner>
Hopefully, once we
get my new book on seahorses published and into the hands of the
hobbyists, there won't be a need for us to devote so much
time discussing these issues on the forums.
<Heeeeee! You'll
see...>
Happy Trails!
Pete Giwojna
<And to you, Bob
Fenner, out in HI, at times visiting with Carol and Craig and their
(now four year old!!!) boys, Dylan and Cooper> |
Swallowing water
Hi Bob,
I have a marine tank (46 ga.)that has
been up for about 5 months. I houses a blue damsel, percula clown, coral
beauty, yellow tang, cleaner shrimp, and a few crabs and snails. During
routine maintenance this weekend while siphoning water out for a water
change, I guess you could say that I swallowed a bit of water trying to
start the siphon. I remember "drinking" some of the ocean water as a kid
at the beach, but I'm sure the water in our tanks is a little more "full
of waste" than the ocean. It happened 2 days ago. I feel fine. Anything
I should worry about? Thanks.
<Not really... unless you have
ulcerations... open wounds in your buccal cavity... you're more than
likely fine... I have swallowed actual gallons of water from fish tanks
over the years... though I am the "Jimi Hendrix" of siphoning at this
late stage. Bob Fenner>
Jason Human Poisoning from
Sarcophyton?
Anthony- After a somewhat panicked web search, I
came across your article:
http://www.reefkeeping.com/issues/2002-06/ac/feature/
on coral
propagation in Reefkeeping magazine. I say "panicked" because while I
was attempting to cut a diseased portion of a Sarcophyton species off, I
inadvertently cut my finger in the process. The cut was shallow; so
shallow that I did not realize I cut myself until the "operation" was
complete, and it did NOT draw blood. However, I'm worried about any
toxic reaction. It's been two hours as I write this, with no sign of
rash or anything at the cut site, or any symptoms that can't be
explained by panic disorder. Are there any warning signs/window of time
I should be looking out for a "bad" reaction? Is it possible I
introduced something harmful or lethal via this shallow cut? I
feel incredibly stupid for (a) doing this and (b) e-mailing someone I
don't know about it, but I'd really like the opinion of an authority on
this so I can rest easy or get myself to the hospital. Thank you very
much for your time.. -Todd
<Cheers, Todd. Very glad to hear about the
propagation efforts! Sorry to hear you got a scare :p No worries though
my friend. Nothing imminent is likely regarding a poisoning or allergic
reaction. What risk there is no worse than the same risk of being bit or
stung by a non-venomous fish or even simply putting your hand in the
tank on a daily basis with a hangnail or other non-related wound.
Specifically, there are nasty microbes in all aquatic environments and
specifically we fear Vibrio or Mycobacterium. Your first step of
course was/should be to cleanse the wound thoroughly with soapy water
and then use a disinfectant (antibiotic cream, peroxide, or the like).
The doctor is unlikely to be necessary but do call at least to get his
advice. Really... the concern here is more from a septic infection from
the razor than anything the coral could impart. Sarcophytons are
specifically noxious to other corals and aquatic invertebrates with
regard for allelopathic compounds. Again, since this is not an overtly
poisonous (to humans) animal and you didn't even draw blood... it seems
likely that you will have a very nice holiday week. The only poisoning
that I see as being likely in your near future is alcohol poisoning
tomorrow night <G>. Happy New Year, my friend. Anthony>
Sore Fingers...Infection from My Saltwater Tank?? - 8/13/03
Hi all at WWM. I have a pretty serious question to ask of you, I
hope someone can get back to me (I've sent you another email about
some live rock with no response so I hope this one makes it)
First off, I love your site and have learned a great deal from you
all! Me and my fish appreciate all the hard work u put into it. I
am just venturing into the hobby of saltwater fish and have just
completed setting up my tank. About 5 or 6 weeks ago I purchased
some live un-cured Lalo rock from an online store. When it arrived
I rinsed in some saltwater which took me quite a while and placed it
in the tank. As I was finishing up I noticed that my thumb (also my
first 2 fingers but more so my thumb) on my right had had gotten
very tender and was a bit red. I put it off to abrasions from
handling the rock etc. But, over the course of the next few days
my thumb and fingers felt worse. They were reddish/purplish,
slightly swollen, warm feeling and felt like
razors or pins were
in the pads of my thumb and the same 2 fingers. Anyway, over the
course of the next 5 or 6 weeks all my fingers except my pinkies
(and they are starting to get sore now a little bit) have developed
the same symptoms. All those symptoms seem to be isolated to the
pads of my fingers. Now this morning I noticed that I have like
these little white circle/spots/bumps under the skin but some are
raised slightly. They hurt when I try to feel them, again like a
razor is in there. They look like white things about the size of a
sesame seed pushing up from under my skin on the pads of most of the
fingers. I also have a few that are now on the side of my finger. I
went to my doctors today and they had no idea what it was. They put
it under the heading contact dermatitis and to come back in 2-3 wks
if it didn't get better. I told her that I was concerned that I may
have gotten something from handling the live rock with no gloves on
(maybe even crystals of some sort got caught under my skin??) She
thought I was basically crazy and said she wasn't aware of any
infections etc. that I could get from live rock (she didn't even
know what LR was till I told her!) I really hope you have an idea or
suggestion as to what this may be. I have done extensive research
on your site and also found names of things (infections etc.) and
done a web search but I'm still not sure of what this is. I hope
its not marine TB, I don't think it looked like the pictures I saw
but I'm getting worried that it is going to get worse instead of
better. (its already been like 6 weeks and hasn't gone away)
Please, any help would be of great help. As I said, 2 of my
others emails never got answered (maybe not great ?? LOL) but if for
some reason you do respond to me without using the reply
button, the "0" in my screen name is actually a zero, not the
letter o. Desperately awaiting a reply, Jan
<Jan... please do
seek another doctors opinion. Also, read our coverage on diseases
and mycobacterium as well as another former a colleague of ours (may
not apply to you... but I hope it frightens you into wearing gloves
properly to handle live rock!). My first impression from your
symptoms stated was that you got calcareous spicules embedded into
your skin from handling a sponge (common) or that you got setae
(bristles) from segmented worms in there. This would definitely
cause a prickly feeling like fiberglass in the skin. Please do seek
a doctor with experience in aquatic pathogens. Likely little to
worry about... but do play it safe. Speedy recovery, my friend! And
please do give us a follow-up later. Kindly, Anthony
http://www.wetwebmedia.com/Wound.htm
http://reefkeeping.com/issues/2003-07/sp/feature/index.htm >
Sore Fingers... Infection from My Saltwater Tank: Follow-up -
8/21/03
Hi crew at WWM...I just wanted to give you a follow
up email about my fingers.
<much appreciation!>
So as it
turns out my symptoms were getting worse over the past week - the
little bump things started to move up the sides of my fingers, they
appeared on the palms of my hands and near my wrist. Then Saturday
morning I woke up and the joints in 3 of my fingers were really
sore.
<yowsa...>
I called my Dr's office and got an
appointment with the infectious disease doctor who finally saw me
today....as it turns out I do in fact have a mycobacterium marinum
infection.
<Doh! I hate when that happens>
(I'm pretty ticked
at my Dr. as I originally asked her to look up M. Marinum and she
told me to calm my "bacteria imagination" down. Obviously she had
no clue eergh)
<don't be too upset... keep in mind that few
doctors (inland particularly) ever see the pathogen. Most go a
lifetime and never do. You did the appropriate thing by seeking
other opinions and research>
Luckily I don't have the TB type but
a different strain I guess?
<yep... really no biggie at all
when caught early. Just some meds and the need for a lot of yogurt
after the antibiotics <G>>
Anyhoo, I just filled a prescription
for a pretty strong antibiotic which I'll take twice daily for at
least 3 months.
<ah, yes... have had several friends go through
this... your tummy will be a but upset afterwards, but none the
worse for wear>
Hopefully they won't bother me - he said they
were pretty strong and some people get sick etc. from them.
<heehee... fruit and dairy will not be your friends for a while. Eat
them strategically with green bananas, rice and olives to ...er,
counter the effects. Doh!>
Guess we'll have to see.
I really
wanted to thank Anthony (he happened to be the one to reply to my
original email) for getting back to me with his input and suggesting
I see the infectious disease doctor.
<very welcome my friend>
I guess I've learned my lesson, I really had no idea all the lil'
nasties one could get from an aquarium.
<they are rare... but
it is very important to wear gloves when working with aquatics and
most any creatures in animal husbandry. Few are toilet trained <G>>
I will surely wear gloves whenever my hands/arms go into the tank!
<very good investment>
I've only had the tank a few months and
I'm learning so much from your website. I'm on here everyday
reading every saltwater subject you have! I'm glad that this ordeal
hasn't scared me away from the hobby.
<excellent to hear and
very intelligent. Truly a rare happenstance. No need to avoid your
love and passion for the sea because of it>>
Probably not
possible... besides the clean up crew I only have 2 fish, well 3 if
you consider my "evil" blue damsel a fish LOL but I could watch them
all day! My daughter and I will sit up late at night with the
flashlight checking out the live rock creatures....amazing! Once
again, you guys and gals are terrific. My fish and I thank you for
all the hard work you put into maintaining the site.
<very very
welcome my friend!>
One more thing, I've been trying to purchase
Bob Fenner's book CMA and thought I had seen it available for sale
on your web-site.
<actually from Di his wife direct, but they
have been in Indo for the last two weeks... will be back next week>
I went to purchase it yesterday and can't seem to find the link
anymore. Is it now only available thru the 3 web-stores you have
links for (Di's store etc.)
<not at all... er, that is.. if you
don't want it signed... it is on Amazon.com and numerous other mail
order aquatics places (Custom Aquatic, MarineDepot, Champion Light
and Supply, That Pet Place, Barnes and Nobles, etc)>
I really
wanted an autographed copy and Di's store wouldn't put the order
thru, some error or something so I figured they may have run out.
<ahhh, yes... some glitch due to their absence no doubt. Do try them
again next week my friend>
If you could let me know if its
possible to get it through your site still I'll get it here
otherwise I'll just order it un-autographed ;-) online
somewhere. Jan
<best regards, Anthony> |
Sore Fingers... Just an Update/Reply
Hi again WWM (and
Anthony, my "reply" guy).
<cheers, dear>
Just happened to be
browsing your site (oh alright, I'm here reading everyday!) and
happened to see a reply from a Dr. to my "finger dilemma" post.
<ahhh, yes... Dr. Allen>
If I could clarify my "being ticked at my
Dr." reply that would be great ....the only reason I was a lil' upset at
my Dr. was because when she told me she had no idea what it was and lets
go with c. dermatitis for a few weeks and see if it goes away, I gave
her a paper with the name of (what I thought I had) Mycobacterium and
asked if she wouldn't mind just looking it up for me - not only did she
refuse to look it up she chuckled at me and told me to "calm my bacteria
imagination down"! Mind you that I live on the East
Coast/Boston area so very near the ocean and also telling her my fears
of handling the live rock, I think she should have made an effort to at
least check it out for me while I was there (I even told her about this
site, which is where I originally read of it, and she didn't want to
know...)
<yes... agreed, the dismissive attitude even without your
coastal residency is indeed disappointing>
I just wish she was a big
enough person/dr. to admit she had NO idea and either look it up for me
or immediately refer me to someone else, instead she told me I had c.
derm and that was it...
<truly disappointing>
And yes, I will be
sure to inform her that I actually *do* have what I asked her to look up
for me and not just an over active "bacteria imagination" lol...maybe it
will help some other patient out.
<exactly>
By the way...any idea
of about how long it takes for the antibiotics to start working some
magic? I know its only been about 10 days but my fingers are still
sore/sorer, more bumps appearing <hmmm... variable for folks but slow.
Many stay on the treatment for ~ 4 months to kick it. Quite long as
antibiotics go>
and now I have a stomach ache [sic] a lot of the time
c/o the antibiotics LOL.
<I can only imagine!>
(not to mention
that now I'm wicked creeped out thinking maybe I have bugs/parasites in
my fingers - just kidding, that's just my bacteria imagination kicking
in I guess LOL )
<ha!>
The infectious dis. Dr. told me that they
may not work at all and we may have to switch to a different type of
antibiotics.
<correct... 'tis what I recall from friends>
I may
give a call back to him but was trying to be patient/optimistic. To
make a long email even longer.....I got Mr. Fenner's book, CMA,
yesterday and I LOVE it. I believe I've already read it from cover to
cover!
<outstanding... and do share your wisdom in kind>
Today I
am going to order the Reef I. book as well.
<did get your order...
kind thanks!>
(I really admire both Anthony and Bob not only for
their wealth of knowledge-and humor- but for donating their time to help
us all out on this great site (as all the crew on WWM does!)
<its a
labor of love>
Does the RI book cover sump design/ideas - I wouldn't
have thought it to but I think I read a reply here that stated there
were like 100+ pages designated to that subject?
<roughly 20-30 for
sumps/refugiums... the balance to components like plants, algae, live
sand. And yes... indeed described refugium styles>
As I said in my
last email, I've only had my 55g tank for about 3
months so I'm
still doing a lot of adding/upgrading to it. I want to add a protein
skimmer ASAP but wanted to install a sump first to house all the
equipment and free up the space in the main tank (think I'll put the
sump in my basement where I have lots of extra room and plumb it up) I
have no idea on how this is done so I'll have lots of reading up on it
ahead of me! (change topic)
Any thoughts on compact fluorescent
lights... I'm off to order the custom SeaLife 260W - 2 10k, 2 actinic -
with 4 moonlights for my tank which will be home to fish/inverts and
some *easy* cor A Doctors Input on Fish TB - 8/22/03
<Cheers, Doc :) >
Glad to see on today's post that Jan got to see an
infectious disease specialist as recommended.
<yes... whew!>
Thanks for advising going easy on the primary care doc. You are right
that most of us have never seen this pathogen.
<yes... so true.
Certainly not fair to blame your doctor about some rare and obscure
pathogen. Its unrealistic to expect your doctor, or electronics
technician or broker to know every possible thing there is to be known
in a given industry. Common sense should compel one to get other
opinions if necessary for an intelligent consensus (fortunately this
aquarist did)>
I only learned about it when I became a marine
aquarist. People should never be afraid to question their doc (we're
only human) and seek second opinions if they are skeptical of the first
one.
<true, true... not a bad thing at all. And surely not taken as a
slight by good doctors either.>
It would be worthwhile to politely
inform the first doc of the final diagnosis so that he/she will be aware
of this possibility if seeing an aquarist in the future.
<ahhh...
good point. I wish I had though to mention it. Will be posting as
always.>
Steve Allen, MD
<kind thanks as always, Anthony>
A Nasty Owee 12/9/2003
Good morning,
Yesterday while cleaning
my tank I had a small cut on my thumb. <Did you cut yourself before
putting your thumb in the aquarium or on something inside?> I
accidentally touched the elegance coral and was stung by it. <Ouch!> My
thumb is now swollen, red and tender. <Either a toxic reaction or an
infection.> Should I go see the doctor or give it some time. <Go to the
doctor ASAP. If this redness is spreading, you may have cellulitis, a
potentially serious infection requiring antibiotics.> Also, what is the
active ingredient in the poison. <Uncertain. I could not get any
specifics on the Internet. Most of these toxins are a mix of noxious
things--local irritants, anticoagulants, neurotoxins. Most reactions are
localized burning & swelling, but can be more severe depending on type &
amount of venom. Allergic reaction can be severe. Some aquarists have
had neurological symptoms like numbness & tingling, loss of taste. Check
here for more info:
http://www.emedicine.com/wild/topic18.htm>
Thanks, <You're
welcome. I hope this heals quickly, Steve Allen>
-Brent
<There's a
lesson here for all. It is best to wear arm-length gloves when messing
around in your reef tank. Here's one source:
http://www.drsfostersmith.com/product/prod_display.cfm?pcatid=3871&D=gloves&R=7795&Ntt=gloves&Ntk=
All&Dx=mode+matchallany&Ntx=mode+matchallany&Np=1&N=2004&Nty=1 Also,
NEVER EVER put your unprotected skin into the water if you have an open
wound (scratch, laceration). The tank is a veritable cesspool of
potentially infectious agents and broken skin is an easy access point
for them to infect you. Intact skin is your primary line of defense
against infection.> Fish germs and other yucky microbes--Eww!
(12/08/2003)
hello,
I got a question here. If we handle a fish
which are sick like, body fungus, gill disease, or other disease with
hand without glove, will the disease effect us? or is there any side
effect to us?
thanks. sorry for my bad English. hope u reply a.s.a.p
<While many fish diseases can't infect humans, some do, so it pays to be
cautious. Bacteria are very good at entering the body through the
slightest break in the skin (cut, scratch or scrape) and some (Vibrio,
Mycobacteria) can cause nasty infections. Fungus is probably less
likely, as are the various parasites. Fish tapeworms have been known to
infect humans. If you got tapeworm eggs on your hand and touched your
mouth you might get infested.
The best bet is to always wear gloves
if you need to handle your fish. Latex-free surgical-type gloves from
the local store will provide good protection. If you're going to put
your hand in the tank, it's best to wear arm-length aquarium gloves. In
any case, always wash your hands thoroughly with hot, soapy water or use
an alcohol-based skin cleanser after handling anything that's inside
your aquarium. Steve Allen> Mycobacter marinum
Hi Bob-
While surfing my favorite fish site I came across your article on
Mycobacter marinum. I too had acquired the infection-twice.
The first
time I went to the ER I was given some antibiotics that didn't help. By
my third visit to the ER I was immediately sent to our local plastic
surgeon (the infection was in my right index finger.
I was rushed
into surgery within 30 minutes and stayed in the hospital for 6 days. It
was 4 days before the source of the infection was found.
<Lucky just
the same...>
For this I received massive doses of antibiotics both
orally and by I.V. My finger and hand remained swollen for 6 months
until my second bout of it. By this time I knew what was coming and got
to the Dr. in time to stave off the severity of before.
The surgery
involves opening the infected site and SCRAPING the infected area, on me
it was the ligament sheath, flushing the open wound for 6 days (the
wound needs to stay open so the infection does not get trapped inside
and the wound has to heal from the inside out)
and then to top it off
I need physical therapy 3 times a week for 5 weeks to get mobility back,
even then it was a bit stiff and swollen.
<Yes... very painful,
inconvenient, frightening>
It's been since Jan 7 of this year since
the last bout of this. My finger just now looks to be normal size.
Best precaution??? ARM LENGTH VINYL GLOVES & a MAG FLOAT!!!
Cause of
infection: getting scrapped by live rock while cleaning the inside of
the glass.
Lesson learned!!!!..............................Lance
<Thank you for sharing your harrowing experiences. You have helped many
others. Bob Fenner> More Mycobacteria transzoonoses... It's not
"just a scratch"
Friend of mine is at the hospital now with an
infection he kicked up with a cut in the aquarium. They are telling him
he has a form of Tuberculosis and want to operate. I saw an article
about an infection or bacteria that can be picked up this way but cant
locate it. Can you help. I mentioned this to him a week ago but he
laughed it off. Thanks
<Not, NOT a "laughing matter". Please have
your friend and his health practitioner read here:
http://www.wetwebmedia.com/Wound.htm and more importantly, the
associated FAQs file (linked, in blue, at top). These "aquarium wounds,
infections" can be VERY serious indeed. I wish your friend (and they are
fortunate to have friends like you) good health, recovery. Bob Fenner>
Re: Mycobacterium
Thank you, my friend has been diagnosed with
Mycobacterium marinum and they will operate this week to remove two
granulomas. Aquarists need to be made more aware of this hazard. He was
told he could have faced amputation if he had ignored it much longer.
Thanks for your prompt response. Paul
<And you for your input. Will
be posted, shared. Bob Fenner> Cleaning Fish Tank Can Lead to
Infections
NEW YORK (Reuters Health) - Owners of tropical fish be
warned: Cleaning the fish tank without wearing gloves may get you a
bacterial skin infection, especially if you have an open cut or abrasion
on your hand or a depressed immune system.
Writing in the medical
journal Clinical Infectious Diseases, Dr. C. Fordham von Reyn and
colleagues from Dartmouth-Hitchcock Medical Center in Lebanon, New
Hampshire, describe eight adults who developed sores, mostly on the
arms, after cleaning their fish tanks.
In six of the eight
individuals, lab tests showed the culprit to be Mycobacterium marinum, a
bacterium first identified in dead aquarium fish in 1926. This bug was
found to infect humans in 1951 after being isolated from skin lesions.
The use of chlorine in swimming pools has drastically reduced the number
of skin infections among swimmers. Today, most reported skin infections
linked to the bacterium come from contact with fish tanks.
Antibiotic
therapy took care of the infection in most cases. But one patient's
infection failed to resolve after about two years of drug treatment as
well as attempts to cut out the sores. This patient had a depressed
immune system. He had psoriasis, melanoma, and was taking steroids. .
Fish-tank exposure is the source of "most cases" of M. marinum skin
infections, the researchers warn, and may be preventable by using
waterproof gloves.
SOURCE: Clinical Infectious Diseases, August 1,
2003.
<Thanks Miguel... a growing (awareness) concern. Bob F>
Health Concerns (3/17/04)
Hi Crew, <Steve Allen tonight>
I
wish to thank you for your help in the past with my evolving for tank
into a full blown reef system. <We are always glad to help.> Through
browsing your site I came across the sections regarding bacterial and
viral infections which could possibly be passed from tank/animals to
humans, especially regarding the "various respiratory ailments"
mentioned.
Tank specifications are:- 230G marine FOWLR evolving
slowly to reef. (I do siphon water out by mouth for the record) <Many
people do. I'd suggest spit & rinse right away after, maybe even with
Listerine, but I'm paranoid.>
I'll try to cut a long story short.
1yr 5 mths ago I had what I though was a minor throat infection, the
symptoms being a very dry throat and later in the weeks that followed,
the feeling of a golf ball sized lump in my throat, bellow the "Adams
apple" area. All very frightening until one morning at 2am I found I
could hardly breath. I asked my wife to drive me to the hospital
ER
unit which she did. I was sent home with the diagnosis that I had a sore
throat !!!........That's another story!
Later that day I went back
to the hospital and was immediately admitted and put on antibiotics IV.
The resultant diagnosis was "Epiglotitis" (a swelling of the
vocal chords <actually, its the epiglottis, the lid that prevents food
from going down the trachea>) which can be very serious indeed. <Scary
disease, can be fatal. Many young children used to get this from
Haemophilus influenza B (Hib). Thankfully there's been a great vaccine
available for more than a decade. As a pediatrician, I have not seen a
childhood case in 10 years. It is rare in adults, but can be caused by
other pathogens. I almost lost an adult cousin to it.>
This all came
with hundreds upon hundreds of tiny (but fairly painless) ulcers which
completely coated my mouth and throat. <Definitely not Hib.> They tested
for cancer and all else but had no idea where this had come
from........They were completely at a loss, had no idea. Until, somebody
asked "Do you keep any unusual pets"?..............Well the answer was
yes and still they were none the wiser.
My question to you my good
friends is, have you ever heard of anything even remotely like this
before? I am really struggling to get anywhere with this as I am still
suffering from the lump in the throat and the very dry throat. This is
over a year now and although it comes and goes it is still of some
concern. <Understandable. I trust you have seen an ENT specialist and
had a laryngoscopy and perhaps an MRI. I am not aware of anything from
your tank that would likely cause such a thing, unless you have some
known toxic fish or invert in there. With your problem, I would
certainly advise not starting siphon by mouth, just to be safer. Since
no infectious pathogen was isolated and you are still having problems,
I'd suspect it is some sort of allergic/inflammatory reaction to an
irritant or toxin that you are inhaling from somewhere. Do you get hives
ever? Wheezing or asthma symptoms? Do you work with hazardous materials
in your job? It might be worth consulting an allergist or an
environmental physician.>
Any help at all you may be able to offer
will be very much appreciated With much gratitude. <You're welcome. I
hope this helps a bit. I suggest you continue to work with your doctors
on this one. I hope this problem is solved for you soon.> Simon
Health Concerns 2 (3/17/04)
Many, many thanks for your quick
reply. <You're welcome.> Yes I realize the swelling is the epiglottis
but for general purposes some people may not know where ones epiglottis
is ;-) I have seen the ENT specialist and she had several looks at the
state of the
epiglottis which was indeed very bad and according to
her if I had left it any longer I would not be here now! <Good thing you
went in>.> What is really puzzling me is the fact that they cannot
decide whether it is bacterial or viral? I would have thought if it were
viral then IV antibiotics would not have helped much but they did reduce
the swelling a great deal. <Bacterial diseases are diagnosed by
culturing bacteria from the infected area. Sometimes we are unable to
get anything to grow in culture even when it is there. The fact that
antibiotics helped suggest there was some bacterium involved because, as
you obviously know, antibiotics are not effective against viruses.
Specific viruses are more difficult to diagnose unless there is a
specific, unique syndrome such as chicken pox. We often fail to get a
definitive diagnosis in viral infections.>
I am not presently
suffering from any more of the hundreds of little ulcers, have not had
those for a year now so am just concerned about the lump and the dryness
in the throat. Never had Hives. I do not work with any hazardous
materials. Have had several laryngoscopies. No asthma, no wheezing. <I
just noticed you hail from the UK. It sounds like you NHS specialists
are being thorough.>
Thank you so much for your prompt reply. This
has reiterated my own concerns ie the problem could be "environmental"
but I do have to get to the bottom of this. <Yes. I hope you do soon.>
Again if you hear of or find out anyone else has suffered anything
similar
would you be kind enough to let me know. <Do consider posting
this dilemma on the forum at www.wetwebmedia.com The forum "Zo's Bar &
Grill" is read by a lot of our users and if any o them have any ideas,
they'll chime in.> Cheers.........Simon <I hope you are restored to full
health soon. Steve Allen.>
Pet-fish owees!
Bob:
This picture accompanied a brief
article about Mycoplasma marinum in a recent issue of the New
England Journal of Medicine. This is a teaching slide, so it should
be acceptable to post as fair use for education our readers. Steve
<Yowzah. Will post... but not near dinner time. Bob F> | 
|
URGENT! Medical question: Aquarium related Human Skin Infection
(8/13/04)
Greetings crew,
And greetings to you as
well....Leslie here for the crew this evening>
I have a quick and
urgent question for you.
<Sure I will do what ever I can to help
that's what I am here for.>
I am in medical school and a fellow
classmate of mine has a patient that they are following with a rather
serious infection.
<Utto, sorry to hear that>
My
colleague--knowing of my avid passion for marine aquariums-- requested
my help. It seems their patient cut his arm on some rock (assumed live
rock) in their marine aquarium 5 days ago. It is now a very serious
sub-dermal infection taking up the majority of their forearm--serious
enough for hospital admission.
Lab results and cultures
are pending (won't be ready till tomorrow night at least). The patient
is currently on broad-spectrum IV antibiotics.
<Well it sounds like
your friend's patient is in excellent hands, however enlisting the
services of a consulting an Infectious Disease Specialist might be
appropriate. >
My question to you (that was asked of me) is
this: What microbe is most likely to have infected this patient?
<Well the first thing that comes to my mind is Mycobacteriosis caused by
the organism Mycobacterium marinum.
I am not a Physician but I do
work in the medical field as a Registered Nurse and I have had personal
experience with this particular infection.........my experience is
written up in this article which you may find helpful.....
Mycobacteriosis: An Infection You Could Acquire From Your Aquarium
which was published in FAMA but can be found here as well
http://www.syngnathid.org/articles/mycobacteriumInfection.html>
What are the most likely characteristics?
<The
articles and references listed below will give you a pretty good picture
of the characteristics as well as the clinical course, but basically the
organism causes a localized nodule/s typically on the upper extremity.
These are erythematous ranging from 0.5-3.0 cm in diameter, may be
tender and/or actively draining. I can tell you mine was quite painful.
As an addendum to my article I experienced what at the time I thought
were premature peri menopausal symptoms with "hot flashes". Well since
my infection was not diagnosed until it was almost completely resolved
.....in retrospect what was actually occurring were mild low grade
fevers of 99.9 to 100.3 with associated chills alternating with
diaphoresis, on a regular basis, for over a year and long after the
lesion on my arm had almost completely resolved. My annual skin test for
TB was always negative prior to this infection. Now is falsely positive
and additional evidence that despite not having the lesion cultured that
I did in fact have this infection. >
Assuming the aquarium was the
source, and it came from the rock,
I am assuming it is an aerobic
organism. That is about all I can get from my knowledge. I have no
idea if it would be gram positive/negative, motile, coagulase+/-, etc.
< If M. marinum is the culprit then it is a moderate-growing, non motile
photochromogenic, acid-fast bacilli which did not come from the rock as
it is a water borne pathogen. >
Any information you have on this
would be most helpful.
Here are several references
I have found interesting and informative.....
Mycobacterium marinum:
The Fish Disease You Could Catch by Steven Pro: http://reefkeeping.com/issues/2003-07/sp/feature/index.htm
Mycobacterium Marinum Infection of the skin:
http://www.emedicine.com/derm/topic281.htm
Mycobacterium Marinum
Main Index:
http://www.medicinenet.com/mycobacterium_marinum/index.htm
Atypical Mycobacterial Diseases:
http://www.emedicine.com/derm/topic930.htm
http://www.fpnotebook.com/DER129.htm
http://www.medicinenet.com/mycobacterium_marinum/article.htm
There is a photo here in the New England Journal of Medicine in Images
in Clinical Medicine:
http://content.nejm.org/cgi/content/full/350/9/e8
This article
lists a few other aquatic organisms that cause human disease: http://www.freshwater-aquarium-fish.com/articles/human_aquarium_pathogens.htm
Thank you and once again, you (the WWM Crew) are a true credit to the
hobby and a wonderful resource.
<You are most welcome. I hope this
information is useful. Please let us know what the results of your
friend's patient's work up reveal and thank you for the accolades. Best
of luck to you both in your studies and careers, Leslie.>
Photo
Dear Bob,
On your site there was a picture (Steve
Pro's
"owee"...www.wetwebmedia.com/TopicsPIX/Wounds/HandStevePro.jpg)
I am writing a medical-biological book on dangerous marine animals
and I would like to ask if I can use the picture for the book?
With kind regards,
John
<I am the photographer. Is this book
of a commercial nature or more instructional? Bob Fenner> Re:
Photo
Hi Bob,
Although it is used by a few organizations
as a instruction book it is mainly commercial. It is not
supported by the government or something.
John
<I see. As it
is only one image and the topic intended I am inclined to grant its
use. Please do credit myself as the photographer and WetWebMedia as
the source. Bob Fenner> Re: Photo
The sore was
caused by an infection of Mycobacterium marinum. I wrote an
article about it here
http://reefkeeping.com/issues/2003-07/sp/feature/index.htm If
there is any other information or if you have any questions,
feel free to ask me.
Sincerely,
Steven Pro
<Thank you
Steven. I do hope/trust that this writer will ask re disclosing your
name in association with the photos use. Bob Fenner>
Hand Photo
I saw the picture of my hand on the main page of
your website.
<Yes, though Mike.K doesn't quite agree, thought it
was about the best "poster image" for the new "scientific index" for
WWM>
For your information and that of your viewers, the infection
cleared up after three months of three times daily antibiotics. I
cannot remember which antibiotic it was because I had to change
three times before we found one I could take. At the end of the
treatment time, I was cured of the Mycobacterium infection but had a
new problem. Being on antibiotics for such a long time wreaks havoc
on one's digestive system. It took six months of eating yogurt to be
able to have milk and I still have problems with certain fruits
(peaches, strawberries, grapes). Since then I have been using
Coralife's gloves, but they tend to leak. I am looking into gloves
from a vet. I saw some high gloves that were used to help remove a
calf during birth. I am trying to find a source for these now.
Hope all is well,
Steven Pro
<Yes my friend. Do read through
the article, FAQs especially having to do with this phenomena:
http://www.wetwebmedia.com/Wound.htm
Bob Fenner> |
Atypical Mycobacterium and Aquariums (5/11/04)
I have been
diagnosed as having a rare infection, caused by "atypical Mycobacteria".
<Sorry to hear.> (There is a photo posted in the FAQ's -
http://wetwebmedia.com/woundfaq.htm - but my case is not as serious
as the poor guy shown there). <Thank goodness.> My doctor is giving me
special antibiotics, called Minocycline. <Should help, but treatment of
this infection may take a long time.>
My question for you is: Is it
possible that my infection came from my aquarium (freshwater, 150 liter,
tetras). <There are many types of "atypical"--as in
non-TB--Mycobacteria, some from birds and some from fish. Perhaps the
doctor can tell you what species.>
How can I treat my aquarium? <I
would consult a veterinarian with expertise in fish. Perhaps they could
culture the tank. This infection is very difficult to eradicate. It
usually requires a complete takedown and disinfection of the tank and
its contents. The fish need o be treated with antibiotics effective
against Mycobacteria, sometimes by injection. I also recommend never
putting your hands in your tank without wearing gloves. Shoulder-length
aquarium gloves are available online or at many local retailers. Steve
Allen.> Zebra Danios With TB 12/05/2005
Hi,
We have 10 gallon tank and have started the tank 4 months from now. We
bought 3 Danios to start with, and they did very well for first 2.5-3
months. We used to do weekly water change. Our local pet store suggested
to not to change water for first month to have fully cycled tank. We
stopped the water change. I am not sure if this is the cause or
something else, but we lost our smallest fish during this time.
Rest two fishes has lived fine for some time and they started slowing
down. They used to eat a lot and swim around in whole tank that is
filled with natural plants. They stopped eating with that eagerness.
They stopped playing. We noticed that their spine is also got curved.
First we were thinking that they are getting old. After reading FAQ
section in your website, we are scared about fish TB. I have been
touching the water to clean up the tank. Though I don't have any wounds,
but still I am scared and wanted to know what measure we can take to
diagnose if we got infected or not.
About the fishes, now they both
are dull and during the night they lie down on the bottom of tank.
Actually till light is off mostly they lie down on the bottom. If light
is on, they try to swim. We can see they have hard time swimming. They
most stand still at one place. I have also read on internet somewhere
that when they are at the end of their life cycle, then also they
develop curve in their spine. So how do I know if my fishes have TB or
they are just old.
In summary these are questions I have.
1) What
measures can we take to find out if we have infected ourselves with the
fish TB?
< Fish TB is very very rare. If people were getting infected
and it was a problem I think you would see warnings all over the place.
As a precaution I just wash up after having my hands in an aquarium.>
<Rare in people, yes.... but I have seen many, many cases in fish
lately - many of which were Betta splendens.... -SCF>
2)
how do I find out if my fish's spine is getting curved because they are
old or they have fish TB?
< More than likely your fish are getting
old. Usually these little guys don't last more than a couple of years
tops and the contouring of the spine is one of the signs of a fish
getting older.>
3) In case of fish TB, how do I sterilize the whole
tank? Do we have to start from scratch for the new fishes?
< I think
you fish may have gotten ill due to poor water quality. Check the
nitrates. The lower the better. These little guys like clean well
oxygenated water.-Chuck>
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