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Septic Mycobacterium Avium Intracellulare Extensor Tenosynovitis of the Wrist
Daniel G McDermott1, Samantha M Hill1, Kapil Desai2
1ONS Foundation for Clinical Research and Education, Orthopaedic and Neurosurgery Specialists (ONS), Greenwich, Connecticut.
Journal of Wrist Surgery
|May 24, 2023
Summary
Mycobacterium avium intracellulare (MAI) can cause rare but severe hand and wrist infections. Prompt diagnosis and combined surgical and antibiotic treatment are crucial for eradication.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Atypical mycobacterial infections, specifically Mycobacterium avium intracellulare (MAI), are uncommon but can lead to severe musculoskeletal complications.
- Infections of the hand, wrist, and upper extremity by MAI are particularly rare, posing diagnostic and therapeutic challenges.
Observation:
- A case of an immunocompromised patient with acute hand and wrist swelling due to MAI infection is presented.
- The infection progressed to osteomyelitis, tendon ruptures, and skin necrosis despite initial surgical intervention.
Findings:
- Intraoperative cultures confirmed MAI infection following a wrist extensor tenosynovectomy.
- Successful eradication of MAI was achieved through a combination of surgical management and targeted antibiotic therapy.
Implications:
- This case highlights the potential severity of MAI tenosynovitis in the upper extremity.
- The report provides a literature review and outlines recommendations for diagnosing and effectively treating MAI infections in this anatomical region.
Keywords:
atypical mycobacterial infectionmycobacterium avium intracellulareseptic extensor tenosynovitisMore Related Videos
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