title: [Osteo-cutaneous Mycobacterium marinum infection of the elbow and reconstruction with radial collateral artery perforator-based propeller flap].
abstract: Mycobacterium marinum is an atypical and non-tuberculosis mycobacterium that mainly leads to cutaneous infections. Infections occur through inoculation of the organism through injury to the skin in the presence of contaminated water or fish. The patient often presents with unspecific symptoms and the evolution, in the absence of adequate treatment, is characterized by an expansion of the cutaneous lesion and a spread to deep structures. Infections of tendon sheaths and joints are described, rarely osteomyelitis. Sure diagnosis is hard to obtain and is established from the medical history and microbiological examination. There are no specific therapeutic guidelines. Double or triple antibiotherapy is often effective and should be continued several months after complete resolution of clinical signs. Surgical debridement is required in cases of invasive or resistant infections. We report the case of a young immunocompetent fishmonger with a rare osteocutaneous M. marinum infection of the elbow. Treatment included large surgical excision of infected skin and bone areas and a triple antibiotics administration. Reconstruction have been ensured by a radial collateral artery perforator-based propeller flap, satisfying appropriates functional and cosmetical concerns of this anatomical region. Surgery and appropriate antibiotics treatment were effective and allowed healing of an invasive cutaneous and bone M. marinum infection.
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France. Electronic address: pegabert@gmail.com.
authors.forename: P-E
authors.initials: PE
authors.lastname: Gabert
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, centre SOS main, CHU Ch.-Nicolle, 76031 Rouen, France.
authors.forename: L
authors.initials: L
authors.lastname: Lievain
authors.affiliation: Service de chirurgie orthopédique et traumatologique, CHU Ch.-Nicolle, 76031 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Vallée
authors.affiliation: Clinique dermatologique, CHU Ch.-Nicolle, 76031 Rouen, France.
authors.forename: P
authors.initials: P
authors.lastname: Joly
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, centre SOS main, CHU Ch.-Nicolle, 76031 Rouen, France.
authors.forename: I
authors.initials: I
authors.lastname: Auquit Auckbur
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004551:Elbow Joint / Q000382:microbiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007121:Immunocompetence; D009165:Mycobacterium Infections, Nontuberculous / Q000628:therapy*; D019910:Mycobacterium marinum / Q000302:isolation & purification; D010019:Osteomyelitis / Q000382:microbiology* / Q000628:therapy*; D061525:Perforator Flap; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Coude; Elbow; Infection ostéo-cutanée; Lambeau perforant en hélice; Mycobacterium marinum; Osteocutaneous infection; Propeller flap