Mycobacterium marinum as a cause of chronic granulomatous tenosynovitis in the hand

Pang, Hee Nee; Lee, Jonathan Yi-Liang; Puhaindran, Mark E.; Tan, Sheng; Tan, Augustine H. H.; Yong, F. C.

doi:10.1016/j.jinf.2006.11.014

Cited by 34 publications

(35 citation statements)

References 15 publications

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“…A second patient was treated with clarithromycin (500 mg/day for 5 months), with progressive improvement; however, it was necessary to stop the therapy because of persistent nausea [15]. Clarithromycin monotherapy was subsequently used in some anecdotical cases or very small groups of patients at daily doses ranging from 500 mg to 1 g, and for changeable length (from 12 to 281 days, although most authors used the drug for 2-3 months) [12,16,17,18,19,20,21,22,23,24,25,26,27,28]. In most of the patients, except for rare cases in whom clarithromycin was employed at a dose of 1 g/day [13,25,26,27], complete recovery was observed.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Sporotrichoid Fish Tank Granuloma with Pulsed Clarithromycin

Veraldi¹,

Çuka²,

Nazzaro³

2014

Dermatology

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Background: There is no established therapy of choice for Mycobacterium marinum skin infections; clarithromycin monotherapy was used in some anecdotical cases at changeable daily doses and length. Objective: To evaluate the efficacy and safety of pulsed clarithromycin monotherapy. Methods: 29 patients with a clinical diagnosis of sporotrichoid fish tank granuloma were admitted from 2002 to 2013. In 14 patients, the clinical diagnosis was confirmed by history, histopathology and bacteriological examinations. All patients were treated with clarithromycin (500 mg/day for 10 consecutive days/month for 5 months). Results: In 12 out of 14 patients (85.7%) complete clinical remission was recorded. Two patients showed partial remission after 3 months of therapy, but they were lost to follow-up and were therefore not considered evaluable. Conclusion: Our study suggests that pulsed clarithromycin monotherapy is effective and safe in sporotrichoid M. marinum skin infections.

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Section: Discussionmentioning

confidence: 99%

Treatment of Sporotrichoid Fish Tank Granuloma with Pulsed Clarithromycin

Veraldi¹,

Çuka²,

Nazzaro³

2014

Dermatology

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“…Among MOTT-infections presenting with tenosynovitis, infections with M. marinum are well described. Especially fishermen, fishmongers and aquarium enthusiasts are at risk for this type of MOTTinfection [21,22]. Infections with M. abscessus are also possible in risk population [23].…”

Section: Discussionmentioning

confidence: 99%

Tuberculous extensor tenosynovitis of the hand

Probst

Koch

Lohmeyer

et al. 2012

Arch Orthop Trauma Surg

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Tuberculous tenosynovitis is a rare manifestation of extrapulmonary tuberculosis (Tb), especially if solely the dorsal hand compartment is affected. In this report, we present the medical history of an immuno-competent 32-year-old man presented with a painful swelling of the right dorsal wrist. Initial inflammation onset had occurred 6 months before he consulted our service, resulting in consultation of several physicians and extensive diagnostic procedures without gaining a specific diagnosis. Finally, after extensive diagnostic tests, a tenosynovectomy was performed and tuberculosis-induced extensor tenosynovitis was detected. The diagnosis was established by positive histology, repeated specific PCR and T-SPOT.TB. Tuberculous tenosynovitis can easily be overlooked as a cause of chronic tenosynovitis particularly in immunocompetent young people lacking any risk factors.

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“…4,5 There is usually a history of trauma by fish or shrimp, resulting in chronic granulomatous flexor tenosyn- ovitis. 5 In contrast, M abscessus is a rare cause of hand infection, mostly occurring in immunosuppressed patients or in those injected with contaminated injectables.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Severe mycobacterial hand infections can cause debilitating functional loss and can even necessitate amputation surgery. 4, 5 We present 2 cases of severe M abscessus chronic tenosynovitis of the hand in otherwise healthy fish handlers. Our experience highlights the need for heightened awareness of this emerging, highly pathogenic, and chemotherapy-resistant rapid-growing mycobacterium as a cause of chronic severe hand infection in those with fish and aquatic exposure.…”

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confidence: 99%