Wilderness: Fish-Handler's Disease

Medically Reviewed by Jennifer Robinson, MD on August 17, 2022
2 min read

Fish-handler's disease occurs when cuts or scrapes in the skin become infected with the bacteria Mycobacterium marinum. Handling and preparing fish and shellfish can create small cuts and scrapes in the skin where bacteria may enter. Developing fish-handler's disease requires deliberate contact with fish, particularly lobster and other shellfish. Fish-handler's disease occurs worldwide wherever fish and shellfish are handled.

  • A superficial crusted or ulcerated skin nodule can develop
  • Many inflammatory nodules can appear along with a buildup of pus
  • More serious infections could result in arthritis, tenosynovitis (where muscle connects to bone), osteomyelitis (bone infection), bursitis or systemic infections.

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) should be applied 3-4 times per day.

Oral antibiotics are often prescribed to treat the infection. Prior to starting an antibiotic, be sure to tell the doctor about any drug allergies. Sometimes a combination of antibiotics is needed or different treatments for deeper infections. Use sunscreen and wear protective clothing, such as a long-sleeved shirt, pants, and a wide-brimmed hat, while taking these antibiotics because certain antibiotics may cause sensitivity to the sun.

Pain may be relieved with 1-2 tablets of acetaminophen (Tylenol) every 4 hours or 1-2 tablets of ibuprofen (Advil, Motrin) every 6-8 hours.

Consult a doctor about treatment with available medications.

fish-handler's disease, fish handler's disease, fish handler disease, fish, lobster, bacterial infection, fish poisoning, fish hand