Baca-Atlas Michael Howard, Barzin Amir Homayoun
Department of Family Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
BMJ Case Rep. 2017 Dec 22;2017:bcr-2017-221942. doi: 10.1136/bcr-2017-221942.
A 66-year-old man with a history of renal transplant on chronic immunosuppression presented to his primary care physician with a swollen right index finger. On examination, mild swelling was present. Conservative management failed and initial plain films were negative. Corticosteroid injection was performed by orthopaedics, but symptoms recurred several months later and an MRI showed flexor digitorum tenosynovitis and abscesses of the superficialis and profundus tendons. A flexor tenolysis was performed with cultures positive for , a rare, non-tuberculous mycobacterial infection. Treatment was initiated with moxifloxacin, ethambutol and azithromycin daily for nearly 4 months. Repeat MRI 3 months after completion of antibiotics showed near resolution of the tenosynovitis.
一名66岁有肾移植病史且长期接受免疫抑制治疗的男性患者,因右手示指肿胀就诊于其初级保健医生处。检查发现有轻度肿胀。保守治疗无效,最初的X线平片结果为阴性。骨科医生进行了皮质类固醇注射,但数月后症状复发,磁共振成像(MRI)显示指屈肌腱腱鞘炎以及浅肌腱和深肌腱脓肿。进行了屈肌腱松解术,培养结果显示为一种罕见的非结核分枝杆菌感染。开始每日使用莫西沙星、乙胺丁醇和阿奇霉素治疗近4个月。抗生素治疗结束3个月后复查MRI显示腱鞘炎几乎消退。