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An unusually aggressive Mycobacterium marinum infection of the hand that progressed despite surgical and medical treatment is presented.
The infection progressed over a 3-week period after the patient had surgical treatment
and received isoniazid (INH), rifampin, and ethambutol hydrochloride. The patient
had a collar-button abscess, destruction of the metacarpophalangeal (MCP) joint capsule,
flexor and extensor tenosynovitis, and metacarpal and proximal phalanx bone destruction
at the MCP joint and metacarpal shaft. Although atypical mycobacterial infections
of the hand are usually indolent but persistent, this Mycobacterium marinum hand infection progressed rapidly, even with surgical and medical treatment. A judgment
was made to perform an index ray amputation. With a more complete excision of the
infected tissue, there was a higher probability of controlling this severe infection.
The patient was treated with antituberculosis medications for 6 months and is doing
well 1 year after the operation.
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References
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Article info
Publication history
Accepted:
September 16,
1985
Received:
June 14,
1985
Identification
Copyright
© 1986 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
