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J Wrist Surg 2023; 12(03): 273-279
DOI: 10.1055/s-0042-1749446
Case Report

Septic Mycobacterium Avium Intracellulare Extensor Tenosynovitis of the Wrist

Daniel G. McDermott 
1   ONS Foundation for Clinical Research and Education, Orthopaedic and Neurosurgery Specialists (ONS), Greenwich, Connecticut
,
Samantha M. Hill
1   ONS Foundation for Clinical Research and Education, Orthopaedic and Neurosurgery Specialists (ONS), Greenwich, Connecticut
,
Kapil Desai
3   Department of Radiology, Greenwich Hospital, Greenwich, Connecticut
,
Dana Jaggessarsingh
4   Department of Pathology, Greenwich Hospital, Greenwich, Connecticut
,
Mark A. Vitale 
1   ONS Foundation for Clinical Research and Education, Orthopaedic and Neurosurgery Specialists (ONS), Greenwich, Connecticut
2   Department of Orthopaedic Surgery, Greenwich Hospital, Yale-New Haven Health, Greenwich, Connecticut
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Abstract

Mycobacterium avium intracellulare (MAI) infections of the hand, wrist, and upper extremity are rare, but potentially devastating atypical mycobacterial infections that can affect tendon, bone, and other soft tissues of the musculoskeletal system. We present an immunocompromised patient presenting with acute swelling and pain in the dorsum of the hand and wrist that underwent a wrist extensor tenosynovectomy with intraoperative cultures revealing infection with MAI. The patient developed severe progression of the infection with osteomyelitis of the distal forearm and carpal bones, multiple subsequent extensor tendon ruptures, and dorsal skin necrosis. The infection was eradicated with a combination of surgical treatment and antibiotic therapy. The case is discussed in context of the prior scant literature of infectious tenosynovitis of the hand, wrist, and upper extremity caused by MAI. This case report and literature review outline recommendations for diagnosis and effective treatment of MAI.

Keywords

atypical mycobacterial infection - mycobacterium avium intracellulare - septic extensor tenosynovitis


Publication History

Received: 11 August 2021

Accepted: 23 February 2022

Article published online:
13 June 2022

© 2022. Thieme. All rights reserved.

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