title: Atypical Mycobacterium infections of the upper extremity.
abstract: BACKGROUND
  We encountered five patients with atypical Mycobacterium infections in the upper extremity, and examined their outcomes.
  
  
  METHODS
  Two patients were male and three were female. The average patient age was 67 (range, 63-75) years. A wide synovectomy was performed to diagnose all cases followed by a therapeutic regimen of Rifampicin, Isoniazid, and Ethambutol.
  
  
  RESULTS
  The causative atypical organism was Mycobacterium marinum in three cases and Mycobacterium intracellulare in two cases. In one patient, inflammation recurred or did not disappear, and, therefore, three debridements were necessary. The average duration of antimicrobial therapy was 12 (range, 5-24) months. The average follow-up period was 26 (range, 5-66) months, and resolution had been achieved in all cases at the time of follow-up evaluation.
  
  
  CONCLUSIONS
  Surgical debridement and appropriate mycobacterial culture or PCR method are critical to enable diagnosis and appropriate management.
authors.affiliation: Department of Orthopaedic Surgery, Kochi Medical School, Nankoku, Japan. noguchim@kochi-ms.ac.jp
authors.forename: Masataka
authors.initials: M
authors.lastname: Noguchi
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Taniwaki
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Tani
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D003646:Debridement; D004359:Drug Therapy, Combination; D005260:Female; D006225:Hand / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000188:drug therapy; D015269:Mycobacterium avium Complex / Q000302:isolation & purification*; D019910:Mycobacterium marinum / Q000302:isolation & purification*; D013717:Tenosynovitis / Q000382:microbiology* / Q000628:therapy
chemical_list: D000995:Antitubercular Agents