McDermott Daniel G, Hill Samantha M, Desai Kapil, Jaggessarsingh Dana, Vitale Mark A
ONS Foundation for Clinical Research and Education, Orthopaedic and Neurosurgery Specialists (ONS), Greenwich, Connecticut.
Department of Radiology, Greenwich Hospital, Greenwich, Connecticut.
J Wrist Surg. 2022 Jun 13;12(3):273-279. doi: 10.1055/s-0042-1749446. eCollection 2023 Jun.
(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.
手部、腕部和上肢的鸟分枝杆菌感染（MAI）较为罕见，但却是可能造成严重破坏的非典型分枝杆菌感染，可累及肌腱、骨骼及肌肉骨骼系统的其他软组织。我们报告一例免疫功能低下患者，其手部和腕部背侧出现急性肿胀和疼痛，接受了腕部伸肌腱鞘炎切除术，术中培养显示感染了鸟分枝杆菌。该患者感染严重进展，出现前臂远端和腕骨骨髓炎、多次伸肌腱断裂以及背部皮肤坏死。通过手术治疗和抗生素治疗相结合的方式根除了感染。结合此前关于MAI所致手部、腕部和上肢感染性腱鞘炎的少量文献对该病例进行了讨论。本病例报告和文献综述概述了鸟分枝杆菌感染的诊断和有效治疗建议。
