Mycobacterium chelonae hand infection: a review.
Six cases of culture-proven Mycobacterium chelonae tenosynovitis were identified through retrospective chart review. Fifteen cases were identified using computerised Medline search. Clinical features, treatment and outcome were described. Infection control was achieved in our patients with an average of 3.2 surgeries each and antibiotic treatment for six months to one year. Eleven published cases were managed by combined surgery and systemic antibiotics, with an average of 1.73 surgeries per patient and seven weeks to 24 months of antibiotics. All our patients were disease free on final follow-up. Thirteen cases were resolved. Functional outcomes were reported for eight cases. Comparison of functional outcome was not possible because different parameters were used in different reports. Aggressive debridement, susceptibility-guided antibiotics, and supervised rehabilitation resulted in infection control and acceptable hand function for our patients. Standardised data collection on subsequent cases would facilitate outcome monitoring and formulation of a treatment guideline for this disease.
Lee
Ellen Y
EY
Division of Hand and Foot Surgery, Department of Orthopaedics and Traumatology, University of Hong Kong, Queen Mary Hospital, Hong Kong, China. dr_ellen_lee@yahoo.com
Ip
Josephine Wing-Yuk
JW
Fung
Boris Kwok Keung
BK
Ted U
Edmond
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006225:Hand / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000628:therapy*; D016926:Mycobacterium chelonae; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012008:Recurrence
D000900:Anti-Bacterial Agents