A mariner's tale: Invasive endotracheal Mycobacterium marinum infection.

is a ubiquitous water-borne non-tuberculous mycobacterial (NTM) pathogen. In humans, infections are acquired through direct inoculation of skin wounds and are almost exclusively localized to skin and soft tissues. Pulmonary infection with is extremely rare, and to our knowledge, invasive endobronchial disease has not been reported. Here, we present a case of a 71-year-old immunocompetent male surfer with invasive endotracheal granulomatous disease. The patient was successfully cured with a regimen of azithromycin 250 mg daily, ethambutol 900 mg (15 mg/kg) daily and rifampicin 600 mg daily for 12 months following culture conversion. This case highlights several important concepts: Firstly, infection, including invasive endobronchial infection, should be considered a rare cause of NTM pulmonary disease. Secondly, endotracheal infection can be successfully eradicated with this selected therapeutic regimen. Finally, the absence of . skin or soft-tissue infection in this patient, raises the possibility that human disease might also be acquired via inhalation of . contaminated water in rare circumstances.