From the Houston Methodist Orthopedic and Sports Medicine, Houston, TX.
J Am Acad Orthop Surg Glob Res Rev. 2021 Jan 12;5(1):e20.00047. doi: 10.5435/JAAOSGlobal-D-20-00047.
Renal transplant recipients are at an increased risk of atypical nontuberculous mycobacterial (NTM) infections. Infections caused by NTM are uncommon in the general population, rarely occurring in immunocompetent individuals. NTM infections are an uncommon cause of tenosynovitis. Mycobacterium marseillense is a rare, atypical mycobacteria that has been reported to cause pulmonary and cutaneous infections; however, no previous reports of this pathogen causing tenosynovitis exist. This case reports a 73-year-old male renal transplant recipient who presented with chronic extensor tenosynovitis of the right hand caused by M marseillense. The patient was treated with radical extensor tenosynovectomy and 6 months of antibiotic treatment. A review of literature on tenosynovitis caused by atypical mycobacteria was performed. The patient successfully responded to treatment with no complications or recurrence of infection at the 18-month follow-up. Tenosynovitis of the hand caused by atypical mycobacteria is rare. A high index of suspicion is required to prevent a delay in diagnosis, particularly in immunocompromised individuals.
肾移植受者发生非典型非结核分枝杆菌（NTM）感染的风险增加。NTM 感染在普通人群中并不常见，在免疫功能正常的个体中很少发生。NTM 感染是腱鞘炎的不常见原因。马赛分枝杆菌是一种罕见的非典型分枝杆菌，已被报道可引起肺部和皮肤感染；然而，尚无该病原体引起腱鞘炎的先前报告。本病例报告了一名 73 岁男性肾移植受者，他因 M. marseillense 引起右手慢性伸肌腱腱鞘炎。患者接受了根治性伸肌腱滑膜切除术和 6 个月的抗生素治疗。对由非典型分枝杆菌引起的腱鞘炎的文献进行了回顾。在 18 个月的随访中，患者成功接受了治疗，没有并发症或感染复发。手的腱鞘炎由非典型分枝杆菌引起较为罕见。需要高度怀疑以防止诊断延迟，尤其是在免疫功能低下的个体中。
