Mycobacterial tenosynovitis of the hand in a patient with systemic lupus erythematosus

Septic Mycobacterium Avium Intracellulare Extensor Tenosynovitis of the Wrist

“…8 29 30 31 Surgical debridement was performed on 39 of 42 cases found in the literature. 1 2 3 4 5 7 8 9 10 11 12 13 14 16 17 18 19 20 21 22 23 24 25 26 27 28 Thirty-four patients needed a combination of surgical debridement and antibiotics. 1 2 3 4 7 8 9 10 11 12 13 14 16 17 18 20 21 22 24 25 26 27 28 There were only five cases in which the infection was successfully treated only with debridement 5 19 22 23 26 and only two cases in which antibacterial therapy alone was able to eradicate the infection.…”

“…1 2 3 4 5 7 8 9 10 11 12 13 14 16 17 18 19 20 21 22 23 24 25 26 27 28 Thirty-four patients needed a combination of surgical debridement and antibiotics. 1 2 3 4 7 8 9 10 11 12 13 14 16 17 18 20 21 22 24 25 26 27 28 There were only five cases in which the infection was successfully treated only with debridement 5 19 22 23 26 and only two cases in which antibacterial therapy alone was able to eradicate the infection. 6 15 Thus, it appears prudent to apply both surgical debridement and antibiotic therapy in the treatment of infection with MAI; the use of both surgical debridement and antibiotic therapy was effective in the present case.…”

“…Tenosynovial infections of MAI of the hand and wrist have been rarely reported, but they can occur through direct inoculation or disseminated pulmonary disease. 2 The most common presentations of MAI tenosynovitis of the hand or wrist have been acute flexor tenosynovitis, 1 2 4 5 6 7 8 9 10 11 12 14 16 17 18 19 20 21 22 23 24 25 26 27 28 carpal tunnel syndrome, 4 6 7 8 10 11 16 17 18 19 20 26 27 and, less commonly, osteomyelitis 1 2 3 5 9 14 16 18 20 21 or septic arthritis. 2 3 5 9 18 20 Consensus for treatment is lacking, although published reports have shown that a combination of surgical excision and/or long-term antimycobacterial therapy has been successful.…”

Refractory tenosynovitis with ‘rice bodies’ in the hand due to Mycobacterium intracellulare

“…MAC tenosynovitis is a refractory infectious disease, reported more commonly in Asians [ 1 – 3 ]. Most patients have an injury history and often require multiple operations as in this case [ 1 – 4 ].…”

“…MAC tenosynovitis is a refractory infectious disease, reported more commonly in Asians [ 1 – 3 ]. Most patients have an injury history and often require multiple operations as in this case [ 1 – 4 ]. The presence of ‘rice bodies’ is a characteristic intraoperative finding as well as tuberculosis [ 3 , 5 ].…”