An uncommon cause for a common complaint

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Microbiology

Background:

• Carpal tunnel syndrome (CTS) is a common condition often caused by various factors.
• Infective tenosynovitis is an uncommon etiology of CTS.
• Atypical mycobacterial infections are rare causes of tenosynovitis.

Observation:

• A case of Mycobacterium kansasii tenosynovitis of the flexor tendons presenting as carpal tunnel syndrome in Australia is reported.
• The patient did not present with typical risk factors for atypical mycobacterial infection.
• Diagnosis was established during carpal tunnel surgery.

Findings:

• Mycobacterium kansasii was identified as the causative agent of tenosynovitis.
• Histology and specific microbiological cultures were crucial for identifying the atypical mycobacteria.
• The infection led to significant flexor tendon tenosynovitis, mimicking common causes of CTS.

Implications:

• This case underscores the importance of considering atypical mycobacteria in the differential diagnosis of tenosynovitis, particularly in the context of carpal tunnel syndrome.
• High clinical suspicion, thorough histological examination, and appropriate microbiological cultures are essential for diagnosing rare infections.
• Early and accurate diagnosis is critical for effective management and preventing complications associated with infective tenosynovitis.