Fisherman’s Dilemma: Disseminated Mycobacterium Marinum in an Immunosuppressed Patient

A 54 year-old male with a history of ankylosing spondylitis on treatment with infliximab presented with a 6-month history of progressive skin lesions. The initial lesion developed as a single nodule on the right leg following an abrasion while fishing for oysters in fresh water. Four months later, the lesions abruptly spread to involve the remainder of his trunk and extremities. Additionally, the patient reported developing intermittent fevers, night sweats, and painful swelling in his hands and wrists as well as a dry cough.