<i>Mycobacterium Marinum</i> Infection of the Hand and Wrist

Cheung, Jason Pui Yin; Fung, Boris; Ip, WY; Chow, Sherman S. M.

doi:10.1177/230949901202000216

Cited by 49 publications

(49 citation statements)

References 11 publications

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“…The clinical picture of the patient is in agreement with the few cases elucidated in the literature [10]- [12]: nonspecific signs; a slow and chronic evolution; inflammatory signs discrete or absent. This insidious evolution becomes corollary of a chronicity which can be responsible for advanced lesions [13].…”

Section: Discussionsupporting

confidence: 88%

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Giant Bursitis of Wrist and Multiple Tenosynovitis of Hand with Rice Body Formation: Unusual Case of an Atypical Mycobacteria Infection

Samba¹,

Léopold²,

Moctar³

et al. 2016

OJRA

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We report an unusual manifestation of nontuberculous mycobacterial infection characterized by a giant bursitis on wrist and multiple tenosynovitis with many rice bodies formations. The clinical and radiological examinations are neither rather sensitive nor rather specific. The nuclear imagery of rice bodies formations provides elements of guidance. Cause of absence of the germ isolation, diagnosis was retained on probability items based on a suspicion of arguments beam: clinical, biological, bacteriological and histological. The patient was treated with medical and surgical procedure and provided a satisfactory evolution. At follow-up of 15 months, there were no clinical signs of local recurrence. Through a literature review, the problem of diagnosis of certainty will be discussed.

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Section: Discussionsupporting

confidence: 88%

“…In literature [10]- [12] NTM tenosynovitis have been reported, but ours is unique because of its scope to five flexor tendons and the simultaneous combination of giant bursitis of wrist. Moreover bursitis wrist is still less exceptional topography and its association with rice bodies is another interest of this work.…”

Section: Discussionmentioning

confidence: 82%

Giant Bursitis of Wrist and Multiple Tenosynovitis of Hand with Rice Body Formation: Unusual Case of an Atypical Mycobacteria Infection

Samba¹,

Léopold²,

Moctar³

et al. 2016

OJRA

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“…Chen et al 8) reported 12 months of oral antibacterial therapy with CAM, EMB, and RFP without recurrences during an 18-month follow up. Cheung et al 16) reported a case series of 166 patients who had or were suspected of having Mycobacterium marinum infections. In this report, the mean duration of oral antibacterial therapy was 7.2 months; however, the duration of anti-bacterial therapy did not affect functional outcome.…”

Section: Discussionmentioning

confidence: 99%

Non-tuberculous Mycobacterium or Fungus Induced Chronic Tenosynovitis with Rice Body of the Hand

Yamamoto

Tada

Suganuma

et al. 2017

J Hand Surg Asian-Pac Vol

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Background: Chronic tenosynovitis of the wrist and hand is commonly seen by orthopedists, especially hand surgeons. However, cases with rice body formation are comparatively rare. Thus, we retrospectively reviewed the cases of chronic tenosynovitis in our department and evaluated the necessity of antibiotic therapy in the early post-surgical stage. Methods: We analyzed the medical and surgical records of patients who had undergone surgery for chronic tenosynovitis with rice body formation in our department from 1997 to 2015. We evaluated the causes of chronic tenosynovitis, culture findings, pathological findings, and post-operative treatment courses. Results: Nineteen patients with 23 involved hands underwent surgery for chronic tenosynovitis, and 9 patients had rice body formation. The most common cause of chronic tenosynovitis was non-tuberculous mycobacteriosis, and other causes were fungal infection and infection of unknown origin. Recurrence was observed in 2 cases of mycobacteriosis and 1 case of fungal infection; 1 case of mycobacteriosis also had a re-recurrence. Conclusions: In the diagnosis of chronic tenosynovitis with rice body formation, it is necessary to consider not only non-tuberculous mycobacteriosis, but also fungal infection as its origin. However, it is difficult to define the cause of synovitis, but in cases in which these infections are suspected, anti-bacterial therapy in the early post-surgical period could be effective.

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“…2 Among patients with M. marinum tenosynovitis, poor functional outcomes are associated with delayed presentation and treatment with injectable steroids. 4 This case also highlights the importance of a thorough history for over-the-counter and traditional medications or other cultural remedies that might be contributing to the patient's presentation. In the case of our patient, manipulation of the area of injury with plant material and mild clinical response to itraconazole therapy indicated possible mixed infection with Sporothrix schenckii, but this was not proven on histopathology and cultures.…”

Section: Diagnosismentioning

confidence: 90%

“…This too is not an uncommon occurrence because the initial injury is often trivial, and the time between initial exposure and onset of clinical symptoms is often long. 1 Treatment delay is a risk factor for deep tissue infection, 3,4 reported in approximately one third of the cases. 2 Among patients with M. marinum tenosynovitis, poor functional outcomes are associated with delayed presentation and treatment with injectable steroids.…”

Section: Diagnosismentioning

confidence: 99%

Sporotrichoid Lesions: An Age-old Conundrum

Nayyar

Taimur

2015

The American Journal of Medicine

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PRESENTATIONA 64-year-old woman presented with erythematous nodules on the left hand, forearm, and upper arm developing over 2 months. A single nodule was first noted on the dorsum of the left hand, followed by progressive development of several similar nodules on the left forearm and upper arm. She also reported a small cut on the left fifth digit with persistent pain, redness, and drainage of clear fluid for several months. Over the course of her illness, the patient had been treated with amoxicillin/clavulanate and then cephalexin but did not notice any improvement. She denied any medical problems, toxic habits, recent trauma to the hand, or exposure to marine water. She was a native of China and had been living in New York City for 29 years with no recent international or domestic travel. She reported gardening at home on a regular basis and said she had been applying plant leaves and thorns to the area of injury on her hand as part of a traditional Chinese remedy. Review of systems was negative for fever, night sweats, weight loss, or joint swelling. ASSESSMENTOn physical examination, the patient's temperature was 37 C, blood pressure was 168/84 mm Hg, and pulse was 80 beats/min. Multiple subcutaneous erythematous nodular lesions were noted on the left upper extremity extending proximally in a linear fashion from the dorsum of the left hand to the forearm and upper arm ( Figure A). A small cut was observed on the palmar aspect of the left fifth digit with mild surrounding erythema, swelling, and minimal drainage of clear fluid. There was no epitrochlear or axillary lymphadenopathy, and the remainder of the physical examination results were normal. The patient had a total white blood cell count of 8800/mL with a normal differential count. Hepatic and renal function were normal. DIAGNOSISThe patient was administered empiric itraconazole for Sporothrix schenckii infection (sporotrichosis) acquired during gardening. Two weeks into the course of therapy, the patient's skin lesions were unchanged with the exception of a few small nodules on the forearm that showed mild interval decrease in size. Biopsy of a nodule was performed. Histopathology showed dense inflammatory infiltrate in the dermis with numerous neutrophils and focal necrosis with surrounding histiocytes, lymphocytes, and plasma cells. Numerous acid-fast positive bacilli were seen on both acidfast and Fite stains. Grocott's methenamine silver stain and periodic acid-Schiff stains were negative for fungi. Culture of the biopsy tissue grew Mycobacterium marinum. On further questioning, the patient recalled antecedent trauma to the left hand from a fish scale while cooking.Our patient's case highlights a common diagnostic dilemma. There are no pathognomonic clinical features of Mycobacterium marinum infection, and delay in diagnosis is common. 1 Most patients present with papules or nodules of the upper extremity. Less commonly, abscess and ulcer formation are seen. 2 Lymphocutaneous spread similar to sporotrichosis, nocardia, and other nontuberculous myc...

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Mycobacterium Marinum Infection of the Hand and Wrist

Cited by 49 publications

References 11 publications

Giant Bursitis of Wrist and Multiple Tenosynovitis of Hand with Rice Body Formation: Unusual Case of an Atypical Mycobacteria Infection

Giant Bursitis of Wrist and Multiple Tenosynovitis of Hand with Rice Body Formation: Unusual Case of an Atypical Mycobacteria Infection

Non-tuberculous Mycobacterium or Fungus Induced Chronic Tenosynovitis with Rice Body of the Hand

Sporotrichoid Lesions: An Age-old Conundrum

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