- See:
Myobacterium tuberculosis
- Discussion:
- causes chronic granuloma of the hand or a sub acute inflammation, which may be difficult to
distinguish from chronic tenosynovitis or chronic inflammation of the fingers or the hand;
- can be confused w/
rheumatoid hand and will temporarily respond
to steroid injection;
- organism is usually associated with swimming, fish handling, ect;
- Clinical Finding:
- painful swelling in the hand;
- subcutaneous mass;
- tenosynovitis, which involves the extensors more frequently then the flexors;
- Gram Stain: utilizes Ziehl Neelson staining;
- Culture:
- culture must be incubated at 30-32 deg (rather than 37 deg), & must be
incubated w/ Lowenstein-Jensen medium - often culture for 6 weeks in required;
- Treatment:
-
ethambutol and
rifampin are curative;
- also consider oral minocycline which has lesser side effects;
- synovectomy and debridement are often required;
Mycobacterium marinum infections of the hand.
L Hurst et al.
J. Hand Surgery. Vol 12-A. 1987. p 428-435.
Experience with atypical mycobacterial infection in the deep structures of the hand.
Year Book: Mycobacterium marinum Infection of the Hand and Wrist: Results of Conservative Treatment in Twenty-Four Cases.
Buruli's ulcer: three cases diagnosed and treated in France.
