Unusual presentation of carpal tunnel syndrome due to Mycobacterium marinum infection of hand

We report a case of a fisherman presenting with a rare and unusual carpal tunnel syndrome due to infection of the hand and wrist. The infection resulted in severe pain, paresthesia and restriction of movement in the hand.Flexor tenosynovectomy, followed by histological and microbiological studies, i...

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Bibliographic Details
Published in:	BMJ case reports Vol. 15; no. 12
Main Authors:	Pai G, Mithun, Bhat, Anil K, M Acharya, Ashwath, Reddy, Shreya Pulli
Format:	Journal Article
Language:	English
Published:	England 19-12-2022
Subjects:	Carpal Tunnel Syndrome - surgery Hand - pathology Humans Mycobacterium Infections, Nontuberculous - drug therapy Nontuberculous Mycobacteria Wrist - pathology Exposures Infections Pain
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Summary:	We report a case of a fisherman presenting with a rare and unusual carpal tunnel syndrome due to infection of the hand and wrist. The infection resulted in severe pain, paresthesia and restriction of movement in the hand.Flexor tenosynovectomy, followed by histological and microbiological studies, indicated the presence of atypical mycobacteria. The patient was started on a combination antimicrobial therapy for 6 months. The patient regained full range of motion and returned to perform daily activities with ease.Diagnosis of infection of the hand is challenging as the presentation mimics other conditions and may have nonspecific histological findings. This atypical mycobacterium may also show resistance to commonly used antitubercular drugs. Hand surgeons should maintain a high index of suspicion of and adopt a multiteam approach to prevent delay in diagnosis for successful treatment.
ISSN:	1757-790X
DOI:	10.1136/bcr-2022-251692