Review Article: Mycobacterium Marinum Infection of the Hand and Wrist

Misdiagnosis and delayed treatment of Mycobacterium marinum infection is common because of its diverse manifestations. This leads to inappropriate use of antimicrobials, extension of the infection from the skin to the tenosynovium, and a poor prognosis (loss of tendons and prolonged immobilisation,...

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Bibliographic Details
Published in:Journal of orthopaedic surgery (Hong Kong) 2010-04, Vol.18 (1), p.98-103
Main Authors: Cheung, Jason Pui-Yin, Fung, Boris, Wong, Samson Sai-Yin, Ip, Wing-Yuk
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Debridement
Epidemiology
Hand
Humans
Immunization
Injections
Medical diagnosis
Mycobacterium Infections, Nontuberculous - complications
Mycobacterium Infections, Nontuberculous - diagnosis
Mycobacterium Infections, Nontuberculous - therapy
Mycobacterium marinum
Rheumatoid arthritis
Sinuses
Skin
Steroids
Tenosynovitis - diagnosis
Tenosynovitis - microbiology
Tenosynovitis - therapy
Wound healing
Wrist
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Summary:Misdiagnosis and delayed treatment of Mycobacterium marinum infection is common because of its diverse manifestations. This leads to inappropriate use of antimicrobials, extension of the infection from the skin to the tenosynovium, and a poor prognosis (loss of tendons and prolonged immobilisation, secondary to multiple debridements and joint contractures). Clinicians should be aware of this type of infection, especially in subjects at risk (fishermen and aquarium enthusiasts), and those with a history of trauma coupled with exposure to water or marine life. A proactive approach to obtain a biopsy for histopathological and microbiological diagnosis is advised. Anti-mycobacterial treatment should be started promptly. The combined use of rifampicin, ethambutol, and clarithromycin appears to be effective, and debridement is indicated in patients with deep-seated infections.
ISSN:1022-5536
2309-4990
DOI:10.1177/230949901001800122