Noguchi Masataka, Taniwaki Yoshimichi, Tani Toshikazu
Department of Orthopaedic Surgery, Kochi Medical School, Nankoku, Japan.
Arch Orthop Trauma Surg. 2005 Sep;125(7):475-8. doi: 10.1007/s00402-005-0042-0.
We encountered five patients with atypical Mycobacterium infections in the upper extremity, and examined their outcomes.
Two patients were male and three were female. The average patient age was 67 (range, 63-75) years. A wide synovectomy was performed to diagnose all cases followed by a therapeutic regimen of Rifampicin, Isoniazid, and Ethambutol.
The causative atypical organism was Mycobacterium marinum in three cases and Mycobacterium intracellulare in two cases. In one patient, inflammation recurred or did not disappear, and, therefore, three debridements were necessary. The average duration of antimicrobial therapy was 12 (range, 5-24) months. The average follow-up period was 26 (range, 5-66) months, and resolution had been achieved in all cases at the time of follow-up evaluation.
Surgical debridement and appropriate mycobacterial culture or PCR method are critical to enable diagnosis and appropriate management.
我们遇到了5例上肢非典型分枝杆菌感染患者，并对其治疗结果进行了检查。
2例男性，3例女性。患者平均年龄为67岁（范围63 - 75岁）。所有病例均行广泛滑膜切除术以明确诊断，随后采用利福平、异烟肼和乙胺丁醇治疗方案。
3例致病非典型病原体为海分枝杆菌，2例为胞内分枝杆菌。1例患者炎症复发或未消失，因此需要进行3次清创术。抗菌治疗的平均持续时间为12个月（范围5 - 24个月）。平均随访期为26个月（范围5 - 66个月），随访评估时所有病例均已痊愈。
手术清创以及适当的分枝杆菌培养或PCR方法对于实现诊断和适当管理至关重要。
