Document Detail


Mycobacterium chelonae tenosynovitis of the hand.
MedLine Citation:
PMID:  15609266     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Tenosynovitis of the hand due to atypical mycobacteria is an uncommon condition. We present a case of tenosynovitis of the hand due to Mycobacterium chelonae in a patient without a recognized penetrating injury, who was treated successfully with clarithromycin and antituberculous medications and without debridement. We reviewed the available literature to summarize the experience with this infectious entity. METHODS: Case report and review of the literature (MEDLINE 1976-2003). Only cases that were sufficiently detailed were included. RESULTS: Twelve cases of upper extremity infection due to M. chelonae have been reported: hand tenosynovitis in most and arthritis in a few. These infections resulted from percutaneous inoculation or hematogenous seeding. The clinical course was indolent initially but insidiously destructive. Previously, treatment always included surgical excision of the infected tissues and antibiotic therapy. This is the first case of M. chelonae musculoskeletal infection that resolved with only antimicrobial therapy. CONCLUSIONS: Musculoskeletal infections by nontuberculous mycobacteria are clinically indistinguishable from those of tuberculosis and diagnosis is usually delayed. Prompt diagnosis of atypical mycobacteria with appropriate antimicrobial treatment may avoid the need for surgical debridement. Relevance We recommend a trial of antibiotics for M. chelonae before surgical debridement.
Authors:
Lourdes Mateo; Gabriel Rufí; Joan M Nolla; Fernando Alcaide
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Seminars in arthritis and rheumatism     Volume:  34     ISSN:  0049-0172     ISO Abbreviation:  Semin. Arthritis Rheum.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-20     Completed Date:  2005-03-29     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  1306053     Medline TA:  Semin Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  617-22     Citation Subset:  IM    
Affiliation:
Rheumatology Unit, CAP Just Oliveras, L'Hospitalet de Llobregat, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Antitubercular Agents / therapeutic use
Clarithromycin / therapeutic use
Drug Therapy, Combination
Hand / pathology*
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Mycobacterium Infections, Atypical / complications*,  drug therapy,  pathology
Mycobacterium chelonae / isolation & purification*,  physiology
Tenosynovitis / drug therapy,  microbiology*,  pathology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Antitubercular Agents; 81103-11-9/Clarithromycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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