Mycobacterium marinum Flexor Tenosynovitis

Mycobacterium Marinum Infections of the Hand: a Report of Three Cases

“…The condition has acquired the more popular name of fish tank granuloma or swimming pool granuloma, although the latter is rare since most swimming pool water is chlorinated, which prohibits development of mycobacterial growth. Most literature concerns case reports and small series (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(20)(21)(22). Some larger series are available (3,4,7,11,14).…”

Imaging Characteristics and Epidemiologic Features of Atypical Mycobacterial Infections Involving the Musculoskeletal System

“…Septic tenosynovitis may also occur in association with adjacent cellulitis. Infection may lead to tendon adhesions; however, penetration of the infection through the periosteum can lead to subjacent osteomyelitis, which may necessitate arthrodesis or amputation [74]. On rare occasions, suppuration, caseation of lesions, and eventually, extensive necrosis of the tenosynovium may occur [41].…”

“…One characteristic manifestation of atypical mycobacterial tenosynovitis of the wrist is the carpal tunnel syndrome [72,74], caused by an inflammation-related increase of the intracompartmental pressure. Clinical features include stiffness or swelling of the wrist, tingling of the affected fingers, or swelling of a single finger (sausage digit) [72].…”

Osteomyelitis and synovitis produced by Mycobacterium marinum in a fisherman

“…However, in recent years the number of reported synovitis cases either as single case reports or as a series of cases has dramatically increased (1, 2, 3, 4, 7, 9-12, 17-19). Nine studies with at least three cases per report have been published (2,3,4,7,(9)(10)(11)(17)(18)(19)); six of the nine studies have been reported since 1983 (2,3,4,9,11,17). Of the patients described in these studies, most had sustained puncture wounds while in contact with fish, crabs, shrimp, or other marine life or had a history of frequent exposure to fish.…”

“…The 10 remaining patients required debridement after antibiotic therapy failed. Other studies report the use of surgical intervention combined with antibiotic therapy to cure the synovitis (9,11,19). One report, however, described an unusually aggressive M. marinum synovitis that progressed despite surgical and antibiotic therapies; amputation of the affected finger was required to control the infection (18).…”