Localized infection comes from an abrasion, scratch, or puncture wound while handling material containing the organisms. In the affected fingers and hands there is pain, burning, stiffness of adjacent joints. The incubation period is 1 to 4 days and the purplish-red swollen area around the site of inoculation spreads peripherally leaving central clearing. There is a slow progression which clears in 3 weeks with appropriate treatment. Treatment is with penicillin, clindamycin,or cephalothin.
Prevention is accomplished with the use of gloves.
The usual setting is a rapidly progressive cellulitis after a water related injury. Leeches carry the aeromonas and this has resulted in stoppage of the use of leeches due to the resultant surgical wound infections. The infection may follow lymphatics and tendon sheaths and appears to infect the superficial cooler body tissues in the extremities. Treatment of the Mycobacterium is with Ethambutol or Rifampin. Length of treatment is controversial clinical resolution is accomplished in 4-6 weeks but some feel that treatment should be continued for 18 months.