Abstract: We reported four cases of granuloma caused by fish stabbing. All the 4 patients were elderly women, had the similar experience of exposure to fish. The lesions were characterized by dark red papules and nodules, one of patients was accompanied by beaded subcutaneous nodules on the upper limb. Histopathology showed granulomatous inflammation. Although the evidence of microbial infection was lacking, it was considered to be diagnosed as non-tuberculous mycobacterial infection, and empirical treatment of rifampicin and clarithromycin was effective.

Key words: swimming pool granuloma, non-tuberculous mycobacteria, Mycobacterium marinum