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, 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.
Cheung
Jason Pui-yin
JP
Department of Orthopaedics and Traumatology, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong. jcheung98@hotmail.com
Fung
Boris
B
Wong
Samson Sai-yin
SS
Ip
Wing-yuk
WY
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003646:Debridement; D006225:Hand; D006801:Humans; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D019910:Mycobacterium marinum; D013717:Tenosynovitis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D014953:Wrist
D000900:Anti-Bacterial Agents