Mycobacterium kansasii Causing Carpal Tunnel Syndrome With Concomitant Pulmonary Mycobacterium tuberculosis Infection

Martin L. Blue, MD, Wyatt G. Payne, MD, Rudolph I. Mannari, Pac, Morriah R. Moffitt, MD, Mbaga G. Walusimbi, MD, Martin C. Robson, MD

Disclosures

South Med J. 2002;95(9) 

In This Article

Abstract and Introduction

Mycobacterium kansasii is an uncommon cause of infection of the hand. Other atypical mycobacteria that cause hand infections are M marinium, M avium, M intracellularis, and M chelonei. Such infections usually occur around aquatic areas, though sometimes the source of infection is elusive. Inoculation of the atypical mycobacterium into the host occurs usually from a traumatic break in the skin. Patients commonly report a history of fish tank cleaning, oyster shucking, swimming, or other aquatic activities. Several drug regimens have been suggested and used successfully. Surgical intervention is occasionally required for unresponsive or symptomatic cases. Concomitant hand infection and pulmonary tuberculosis is extremely rare. We present a case report of M kansasii infection of the hand and forearm, with carpal tunnel syndrome complicated by concomitant pulmonary M tuberculosis.

Atypical mycobacterial infections of the hand are uncommon in most healthy persons. Mycobacterium marinum and Mycobacterium kansasii are the atypical mycobacteria that most commonly cause hand infections.[1] Various conservative treatment methods have been used effectively in some patients, but there appears to be no consensus on the antibiotic of choice, duration of therapy, or timing of surgical intervention. We present a patient who had carpal tunnel syndrome due to a forearm mass, a history of hand trauma in an aquatic environment, and concomitant pulmonary tuberculosis. This dual infection is rarely described in the literature.

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