{"id":53062,"date":"2025-09-29T08:51:20","date_gmt":"2025-09-29T12:51:20","guid":{"rendered":"https:\/\/piel-l.org\/blog\/?p=53062"},"modified":"2025-09-29T08:51:20","modified_gmt":"2025-09-29T12:51:20","slug":"granuloma-de-las-piscinas-o-de-los-acuarios","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/53062","title":{"rendered":"Granuloma de las Piscinas o de los Acuarios"},"content":{"rendered":"<p><strong>Lcdo. MSc. Fernando G\u00f3mez-Daza*. Dra. Mar\u00eda Ver\u00f3nica G\u00f3mez-Bisogno.<\/strong><br \/>\nValencia, Venezuela<\/p>\n<p><em>Mycobacterium marinum<\/em> es una micobacteria no tuberculosa de desarrollo lento que causa enfermedades cut\u00e1neas mediante inoculaci\u00f3n directa, t\u00edpicamente acompa\u00f1ada de lesiones traum\u00e1ticas provocadas por fuentes acu\u00e1ticas o ambientales contaminadas. La infecci\u00f3n por <em>M. marinum<\/em> tiene presentaciones cl\u00ednicas polim\u00f3rficas. A menudo aparece una p\u00e1pula o n\u00f3dulo eritematoso solitario en el sitio de la inoculaci\u00f3n en las extremidades, particularmente en las manos, que puede progresar a una placa verrugosa viol\u00e1cea o una lesi\u00f3n ulcerada con secreci\u00f3n serosanguinolenta. La infecci\u00f3n diseminada es rara y ocurre principalmente en los hu\u00e9spedes inmunocomprometidos. La gran mayor\u00eda de los casos afecta solo a un lado de las extremidades. No existen criterios ni pautas espec\u00edficas para el tratamiento de las infecciones cut\u00e1neas causadas por <em>M. marinum<\/em>, pero si se ha propuesto un r\u00e9gimen de 2 agentes activos durante 2 a 4 meses como Rifampicina, Claritromicina, Doxiciclina o Minociclina por v\u00eda oral. En algunos casos se puede recurrir a la cirug\u00eda, termoterapia o crioterapia para lesione localizadas.<\/p>\n<p>El diagn\u00f3stico de la infecci\u00f3n por <em>M. marinum<\/em> sigue siendo dif\u00edcil. Debe sospecharse en pacientes con n\u00f3dulos o placas inflamatorias que aparecen en las extremidades tras un traumatismo cut\u00e1neo seguido de exposici\u00f3n al medio marino, peceras o animales acu\u00e1ticos.<\/p>\n<p>AMJMED 2022.09.002<\/p>\n<p>NEJM 2021; 384: e42<\/p>\n<p>&nbsp;<\/p>\n<p>Casos cl\u00ednicos presentados previo consentimiento informado de los pacientes.<\/p>\n<p style=\"text-align: center;\">\n<div id='gallery-1' class='gallery galleryid-53062 gallery-columns-1 gallery-size-large'><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image1.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"618\" height=\"462\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image1-1024x766.jpg\" class=\"attachment-large size-large\" alt=\"\" aria-describedby=\"gallery-1-53063\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image1-1024x766.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image1-390x292.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image1-768x575.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image1.jpg 1280w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>\n\t\t\t<\/div>\n\t\t\t\t<figcaption class='wp-caption-text gallery-caption' id='gallery-1-53063'>\n\t\t\t\tFoto. 1\n\t\t\t\t<\/figcaption><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image2.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"618\" height=\"464\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image2-1024x768.jpg\" class=\"attachment-large size-large\" alt=\"\" aria-describedby=\"gallery-1-53064\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image2-1024x768.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image2-390x293.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image2-768x576.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image2.jpg 1280w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>\n\t\t\t<\/div>\n\t\t\t\t<figcaption class='wp-caption-text gallery-caption' id='gallery-1-53064'>\n\t\t\t\tFoto 2\n\t\t\t\t<\/figcaption><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image3.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"618\" height=\"345\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image3-1024x572.jpg\" class=\"attachment-large size-large\" alt=\"\" aria-describedby=\"gallery-1-53065\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image3-1024x572.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image3-390x218.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image3-768x429.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image3.jpg 1280w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>\n\t\t\t<\/div>\n\t\t\t\t<figcaption class='wp-caption-text gallery-caption' id='gallery-1-53065'>\n\t\t\t\tFoto 3\n\t\t\t\t<\/figcaption><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image4.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"618\" height=\"463\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image4-1024x767.jpg\" class=\"attachment-large size-large\" alt=\"\" aria-describedby=\"gallery-1-53066\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image4-1024x767.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image4-390x292.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image4-768x575.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image4.jpg 1280w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>\n\t\t\t<\/div>\n\t\t\t\t<figcaption class='wp-caption-text gallery-caption' id='gallery-1-53066'>\n\t\t\t\tFoto 4\n\t\t\t\t<\/figcaption><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image5.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"618\" height=\"349\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image5-1024x578.jpg\" class=\"attachment-large size-large\" alt=\"\" aria-describedby=\"gallery-1-53067\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image5-1024x578.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image5-390x220.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image5-768x433.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image5-1536x867.jpg 1536w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image5.jpg 1790w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>\n\t\t\t<\/div>\n\t\t\t\t<figcaption class='wp-caption-text gallery-caption' id='gallery-1-53067'>\n\t\t\t\tScreFoto 5: Frotis de la secreci\u00f3n te\u00f1ido con Ziehl-Neelsenenshot\n\t\t\t\t<\/figcaption><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon landscape'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image6.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"618\" height=\"348\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image6-1024x576.jpg\" class=\"attachment-large size-large\" alt=\"\" aria-describedby=\"gallery-1-53068\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image6-1024x576.jpg 1024w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image6-390x219.jpg 390w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image6-768x432.jpg 768w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image6.jpg 1280w\" sizes=\"auto, (max-width: 618px) 100vw, 618px\" \/><\/a>\n\t\t\t<\/div>\n\t\t\t\t<figcaption class='wp-caption-text gallery-caption' id='gallery-1-53068'>\n\t\t\t\tFoto 6: Cultivo en agar Sabouraud sin antibi\u00f3ticos 15 d\u00edas de incubaci\u00f3n a 28\u00baC \n\t\t\t\t<\/figcaption><\/figure><figure class='gallery-item'>\n\t\t\t<div class='gallery-icon portrait'>\n\t\t\t\t<a href='https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image7.jpg'><img loading=\"lazy\" decoding=\"async\" width=\"577\" height=\"1024\" src=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2025\/09\/micopiel_granuloma_image7.jpg\" class=\"attachment-large size-large\" alt=\"\" aria-describedby=\"gallery-1-53069\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image7.jpg 577w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2025\/09\/micopiel_granuloma_image7-270x480.jpg 270w\" sizes=\"auto, (max-width: 577px) 100vw, 577px\" \/><\/a>\n\t\t\t<\/div>\n\t\t\t\t<figcaption class='wp-caption-text gallery-caption' id='gallery-1-53069'>\n\t\t\t\tFoto 7: Tinci\u00f3n de Ziehl-Neelsen del cultivo\n\t\t\t\t<\/figcaption><\/figure>\n\t\t<\/div>\n\n<p style=\"text-align: center;\">\n","protected":false},"excerpt":{"rendered":"<p><strong>Lcdo. MSc. Fernando G\u00f3mez-Daza*. Dra. Mar\u00eda Ver\u00f3nica G\u00f3mez-Bisogno.<\/strong><br \/>\nValencia, Venezuela<\/p>\n","protected":false},"author":7,"featured_media":53063,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[],"class_list":["post-53062","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-micopiel"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/53062","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=53062"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/53062\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media\/53063"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=53062"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=53062"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=53062"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}