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Mycobacterium marinum infections of the upper extremity
Christopher L Hess1, Bruce S Wolock, Michael S Murphy
1Division of Plastic Surgery, Medstar-Georgetown University Hospital, Washington, DC 20007, USA. hesschristopher@hotmail.com
Plastic and Reconstructive Surgery
|February 26, 2005
Summary
Mycobacterium marinum infections of the upper extremity require prompt diagnosis and treatment. Early surgical intervention and six months of antibiotic therapy effectively treated patients, highlighting the importance of clinical suspicion.
Area of Science:
- Infectious Diseases
- Hand Surgery
- Microbiology
Background:
- Mycobacterium marinum causes infections, particularly in individuals with aquatic exposure.
- Upper extremity infections present diagnostic challenges.
- The Curtis National Hand Center has extensive experience treating these cases.
Purpose of the Study:
- To review the experience of the Curtis National Hand Center with Mycobacterium marinum infections of the upper extremity.
- To identify key factors in the diagnosis and treatment of these infections.
Main Methods:
- Retrospective review of 29 patients treated for Mycobacterium marinum infections.
- Analysis of patient charts for symptoms, injury correlation, time to diagnosis, diagnostic methods, procedures, and treatment duration.
Main Results:
- The most common symptoms were swelling (86%) and pain (48%).
- Only 69% of patients linked their injury to aquatic activities.
- Mean time from injury to diagnosis was 5.2 months.
- Acid-fast bacilli stains were positive in only 22% of specimens.
- The average number of procedures was 1.75, predominantly tenosynovectomy.
- Mean antibiotic therapy duration was 6 months.
Conclusions:
- Early diagnosis of Mycobacterium marinum infections relies on clinical history, pathological evaluation, and high clinical suspicion.
- Successful treatment involves a 6-month course of antibiotics combined with early surgical intervention.