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Unresolved swelling of the hand: Think of Mycobacterium marinum infection
A Drakou1, M Psifis1, A Mitrou1
1Orthopaedic Department, Laiko Hospital University of Athens, Greece.
Abstract:
The surgical intervention and adjuvant locally applied measures to reduce the impact of a severe cutaneous hand infection caused by Mycobacterium marinum in a 48-year-old diver, receiving anti-TNFa (anti-tumor necrosis factor αlpha) treatment are presented herein. Careful surgical intervention- considered controversial so far-and lateral thinking are essential for the outcome of musculoskeletal infections caused by M marinum. Locally applied disinfection strategies inspired from fields other than medical (e.g. environmental biology) and clearly set surgery goals - aiming at optimizing tissue sampling, antibiotic penetration, decompression while preventing iatrogenic spread are discussed.
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