Abstract
Mycobacterium avium intracellulare (MAI) infections of the hand, wrist, and upper extremity are rare, but potentially
devastating atypical mycobacterial infections that can affect tendon, bone, and other
soft tissues of the musculoskeletal system. We present an immunocompromised patient
presenting with acute swelling and pain in the dorsum of the hand and wrist that underwent
a wrist extensor tenosynovectomy with intraoperative cultures revealing infection
with MAI. The patient developed severe progression of the infection with osteomyelitis
of the distal forearm and carpal bones, multiple subsequent extensor tendon ruptures,
and dorsal skin necrosis. The infection was eradicated with a combination of surgical
treatment and antibiotic therapy. The case is discussed in context of the prior scant
literature of infectious tenosynovitis of the hand, wrist, and upper extremity caused
by MAI. This case report and literature review outline recommendations for diagnosis
and effective treatment of MAI.
Keywords
atypical mycobacterial infection -
mycobacterium avium intracellulare
- septic extensor tenosynovitis
