A case of Mycobacterium scrofulaceum osteomyelitis of the right wrist.
BACKGROUND
The objective of the case report is to highlight the possibility of osteomyelitis caused by atypical mycobacteria. Such an infection may simulate tuberculous bone infection and yet fail to respond to standard anti-tuberculous drug therapy.


METHODS
A 66-year-old man who suffered from diabetes mellitus presented with osteomyelitis of the right wrist, with extensive synovial swellings of the flexor tendon sheaths. The clinical features, radiological appearances and histology suggested a tuberculous infection, but subsequent culture grew an atypical mycobacterium, Mycobacterium scrofulaceum.


RESULTS
There was good clinical improvement and control of the infection with a regime of kanamycin, ethambutol and ethionamide to which the organism was sensitive.


CONCLUSIONS
This case illustrates the need to be aware of the possibility of infection with atypical mycobacteria in cases of suspected tuberculosis of the skeletal system which fail to respond to standard treatment.
Phoa
L L
LL
Department of Medicine, Alexandra Hospital, 378 Alexandra Road, Singapore 159964.
Khong
K S
KS
Thamboo
T P
TP
Lam
K N
KN
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015359:Mycobacterium scrofulaceum; D010019:Osteomyelitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000382:microbiology*; D011859:Radiography; D012008:Recurrence; D013581:Synovial Cyst / Q000601:surgery; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis; D014953:Wrist; D014955:Wrist Joint / Q000382:microbiology
D000995:Antitubercular Agents