Symptoms and Signs of Fish-Handler's Disease

Doctor's Notes on Fish-Handler's Disease

Fish-handler's disease is a general term that describes an illness that may occur after handling fish or other aquatic organisms. Outbreaks have been associated with occupations (fishermen or lobstermen), hobbies (tropical fish tanks, pet shop workers), or water sports (boating, swimming pool use). At least two different types of bacteria (Mycobacterium and Erysipelothrix) tend to cause the disease.

Symptoms of fish-handler's disease caused by Erysipelothrix rhusiopathiae and other species usually develop two to seven days after infection and may include a sharply defined, red-purple circular area that appears and surrounds the puncture wound; the center usually fades, and sometimes a blister-like lesion may appear. The injured area increases in diameter about ½ inch per day. Symptoms that may accompany the infection include joint stiffness, lymph node swelling, and pain, burning, itching, and swelling at the¬†infection site. In rare cases sepsis (infection of the bloodstream) and endocarditis (infection of the heart valves) may occur. Symptoms of fish-handler's disease caused by Mycobacterium species typically develop about two to four weeks after exposure and may include skin lesions (often multiple and linear but can be single) that can develop slowly over months and appear as nodules, abscesses, or ulcers, with skin color changes. Symptoms that may accompany the infection include joint pain, lymph node swelling, and¬†tendonitis. Rarely, sepsis may occur.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019


Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.