harry savage wrote:
> I am trying to get some help with a medical problem possibly involving
> marine microbiology. I am a crabpotter and clammer on the Chesapeake
> Bay and have been experiencing a problem with my hand for about 2
> months. The symptoms are similar to reumatoid arthritis or CTS and
> have made the use of my right hand and wrist almost impossible and
> extremely painful. X-rays and blood work are all normal and my
> doctor, and excellent G.P. practicing in Chincoteague Va. thinks that
> it may be caused by the entry of a rare marine micro-organism into the
> second joint of my middle finger. I often get stuck by the fin of a
> fish while crab potting so this may be possible. He has found a hand
> specialist across the Bay who has dealt with one case of this and is
> sending me to him tomorrow. Since I am self employed with no
> insurance and 2 small children it is important that I get this resolved
> and get back on the water since I haven't been able to work in 2
> months.
> My doctor feels this is a very rare situation and any
> information or experiences having to do with this sort of thing would
> be greatly appreciated.
Harry,
Has your local medical officer considered organisms like _Erysipelothrix
rhusiopathiae_ (often associated with crustacea) or _Mycobacterium
marinum_ (a marine bacterium that requires very special growth
conditions, your LMO has to notify the laboratory of the possibility).
The usual marine bacteria we immediately think of include _Vibrio
vulnificus_, _V. parahaemolyticus_ (this usually causes diarrhoea) and
other _Vibrio_ species. If you do any freshwater stuff, we'd also
consider _Aeromonas_ species. These however, are usually more acute and
cause more fulminating infection. Occasionally they even kill. It's
hard to say without examining you, which outlines one of the dangers of
an indirect diagnosis.
Of cause you might just have a routine run of the mill microorganism
like a _Staphylococcus aureus_ or other _Staphylococcus_ species causing
a low grade osteomyelitis.
Get your LMO to refer you to an Infectious Diseases physician who may
suggest a surgeon see you to get a biopsy.
Let me know how things work out.
Gary
--
******************************************************************
Dr Gary Lum
Director of Microbiology
Royal Darwin Hospital
Microbiologists do it with Culture and Sensitivity
Meet me at my Home page http://www.ozemail.com.au/~glum/index.html
