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Fish-Handler's Disease (cont.)

Fish-Handler's Disease Treatment

Treatment for fish-handler's disease caused by Erysipelothrix rhusiopathiae and other species is as follows:

  • All wounds require immediate cleansing with fresh tap water. Gently scrub the wound with soap and water to remove any foreign material.
  • After cleansing, a topical antibiotic ointment (for example, bacitracin [Neosporin]) should be applied three to four times per day.
  • Oral antibiotics (mainly penicillins) are often prescribed to treat the skin infection. Prior to starting an antibiotic, be sure to tell the doctor about any drug allergies. Continue antibiotics for the entire time recommended by your doctor, even after all signs of infection have cleared. Use sunscreen while taking these antibiotics because certain antibiotics may cause sensitivity to the sun.
  • Pain may be relieved with one to two tablets of acetaminophen (Tylenol) every four hours or one to two tablets of ibuprofen (Advil, Motrin) every six to eight hours.
  • If sepsis develops, almost always endocarditis develops; IV penicillins, cephalosporins, and clindamycin (Cleocin) have been effective in treating these severe infections. However, Erysipelothrix rhusiopathiae and other species are resistant to vancomycin, a drug often used in the treatment of endocarditis.

Treatment for fish-handler's disease caused by Mycobacterium is as follows:

Corticosteroids are generally avoided as they may inhibit treatment and recovery.

Antibiotics such as rifampin (Rifadin), streptomycin, sulfamethoxazole and trimethoprim (Bactrim), tetracyclines, and others have been successfully used to treat the condition; depending on the patient response and severity of infection, length of treatment may vary from about two weeks to 18 months.

  • Severe infection may require IV antibiotics plus the surgical removal of some infected tissues such as tendons and joints.

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