Malisetyan Tatevik, Harmon Skylar R, Reyes Mariafe, Shoja Mohammadali M, Schwartz Gary
Department of Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA.
Cureus. 2024 Apr 22;16(4):e58716. doi: 10.7759/cureus.58716. eCollection 2024 Apr.
Nontuberculous mycobacteria (NTM) are uncommon causes of cutaneous and musculoskeletal infections. Here, we present an immunocompromised patient with persistent swelling in the left hand, wrist, and distal forearm. MRI findings revealed flexor tenosynovitis with synovial hypertrophy of the left hand and wrist and loculated fluid containing rice bodies along the distal flexor digitorum muscles in the volar aspect of the left wrist. The patient underwent flexor tenosynovectomy, and histological examination of the excised tenosynovium and mass revealed noncaseating granulomas. was identified in microbiological cultures. Antimycobacterial therapy was administered postoperatively to manage the infection. This report underscores the significance of maintaining a high index of suspicion for NTM infection when assessing chronic hand swelling, particularly in individuals with compromised immune systems.
非结核分枝杆菌（NTM）是皮肤和肌肉骨骼感染的罕见病因。在此，我们报告一名免疫功能低下患者，其左手、腕部和前臂远端持续肿胀。MRI检查结果显示左手和腕部屈肌腱腱鞘炎伴滑膜增生，以及左手腕掌侧沿屈指浅肌远端有含米粒体的局限性积液。患者接受了屈肌腱滑膜切除术，切除的腱鞘和肿物的组织学检查显示为非干酪样肉芽肿。微生物培养鉴定出了 。术后给予抗分枝杆菌治疗以控制感染。本报告强调了在评估慢性手部肿胀时，尤其是免疫系统受损的个体，对NTM感染保持高度怀疑的重要性。
