{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T10:55:47Z","timestamp":1777114547066,"version":"3.51.4"},"reference-count":9,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,1,17]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:p>\n                    <jats:italic>Mycobacterium marinum<\/jats:italic>\n                    causes a rare, slow-progressing zoonotic infection without distinctive clinical features. History of aquatic exposure increases clinical suspicion. We present a case of disseminated\n                    <jats:italic>M. marinum<\/jats:italic>\n                    infection which progressed from a localised cutaneous infection over 1.5 years. A delayed diagnosis, due in part to a low index of suspicion and underlying CD4 cytopenia, contributed to clinical deterioration. Despite numerous courses of antimicrobial therapy, the patient experienced treatment failure and ultimately succumbed to the disease. Notably, the patient had a longstanding history of traditional Chinese medicine (TCM) consumption, which was later found to contain corticosteroids, contributing to immunosuppression. This case underscores the complexities of diagnosing and managing\n                    <jats:italic>M. marinum<\/jats:italic>\n                    infection in immunocompromised individuals and highlights the importance of thorough medication history-taking, including the use of TCM. Greater awareness of TCM pharmacovigilance is also crucial in preventing inadvertent harm.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-270521","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:46:25Z","timestamp":1770828385000},"page":"e270521","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Disseminated\n                    <i>Mycobacterium marinum<\/i>\n                    infection: diagnostic and therapeutic challenges in an immunocompromised host"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-4875-5623","authenticated-orcid":false,"given":"Wei Hau","family":"Ngan","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences, Newcastle University Medicine Malaysia (NUMed), Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masjudin","family":"Tumin","sequence":"additional","affiliation":[{"name":"Orthopaedic Department, Gleneagles Hospital Johor, Iskandar Puteri, Johor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Foong Kee","family":"Kan","sequence":"additional","affiliation":[{"name":"Medicine, Gleneagles Hospital Johor, Iskandar Puteri, Johor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei Xuan","family":"Tuang","sequence":"additional","affiliation":[{"name":"Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad","family":"Nazri","sequence":"additional","affiliation":[{"name":"Consultant Medical Microbiologist, LABLINK Medical Laboratory, Kuala Lumpur, Federal Territory, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6594-0509","authenticated-orcid":false,"given":"Edmund Liang Chai","family":"Ong","sequence":"additional","affiliation":[{"name":"Medicine, Newcastle University Faculty of Medical Sciences & Newcastle University Medicine Malaysia (NUMed), Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,11]]},"reference":[{"key":"2026021108462050000_19.2.e270521.1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-571ST"},{"key":"2026021108462050000_19.2.e270521.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.15.1746"},{"key":"2026021108462050000_19.2.e270521.3","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-015-0776-8"},{"key":"2026021108462050000_19.2.e270521.4","doi-asserted-by":"crossref","unstructured":"Mohamad Azranyi M , Aziz ZA , Ishak D , et al . Five-year species distribution and antimicrobial susceptibility of non-tuberculous mycobacteria in Malaysia, 2018-2022. J Med Microbiol 2024;73. doi:10.1099\/jmm.0.001809","DOI":"10.1099\/jmm.0.001809"},{"key":"2026021108462050000_19.2.e270521.5","doi-asserted-by":"crossref","DOI":"10.1186\/s41927-020-0114-3","article-title":"Flare or foe? - Mycobacterium marinum infection mimicking rheumatoid arthritis tenosynovitis: case report and literature review","volume":"4","author":"Schubert","year":"2020","journal-title":"BMC Rheumatol"},{"key":"2026021108462050000_19.2.e270521.6","doi-asserted-by":"crossref","unstructured":"Aubry A , Mougari F , Reibel F , et al . Mycobacterium marinum. Microbiol Spectr 2017;5. doi:10.1128\/microbiolspec.tnmi7-0038-2016","DOI":"10.1128\/microbiolspec.TNMI7-0038-2016"},{"key":"2026021108462050000_19.2.e270521.7","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.44.11.3133-3136.2000"},{"key":"2026021108462050000_19.2.e270521.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0041296","article-title":"Fish tank granuloma caused by Mycobacterium marinum","volume":"7","author":"Wu","year":"2012","journal-title":"PLoS One"},{"key":"2026021108462050000_19.2.e270521.9","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s15010-002-2063-8","article-title":"Disseminated cutaneous Mycobacterium marinum infection in a patient with non-Hodgkin\u2019s lymphoma","volume":"30","author":"Enzensberger","year":"2002","journal-title":"Infection"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-270521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:46:27Z","timestamp":1770828387000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-270521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":9,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,11]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bcr-2025-270521"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-270521","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}