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Case Reports
. 2020 Jan 23:26:100283.
doi: 10.1016/j.tcr.2020.100283. eCollection 2020 Apr.

Unresolved swelling of the hand: Think of Mycobacterium marinum infection

A Drakou  1 , M Psifis  1 , A Mitrou  1 , K Zygoggianis  1 , Ourania Argyropoulou  2
Affiliations
Case Reports

Unresolved swelling of the hand: Think of Mycobacterium marinum infection

A Drakou et al. Trauma Case Rep. .

Erratum in

Abstract

The surgical intervention and adjuvant locally applied measures to reduce the impact of a severe cutaneous hand infection caused by Mycobacterium marinum in a 48-year-old diver, receiving anti-TNFa (anti-tumor necrosis factor αlpha) treatment are presented herein. Careful surgical intervention- considered controversial so far-and lateral thinking are essential for the outcome of musculoskeletal infections caused by M marinum. Locally applied disinfection strategies inspired from fields other than medical (e.g. environmental biology) and clearly set surgery goals - aiming at optimizing tissue sampling, antibiotic penetration, decompression while preventing iatrogenic spread are discussed.

Keywords: Anti-TNFa therapy; Mycobacterial musculoskeletal infection; Surgical debridement.

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Figures

Fig. 1
Fig. 1
a. MRI scan of the hand showing the distended extra-capsular, extra-synovial abscesses. b. MRI scan of the forearm depicting the forearm similar lesion.
Fig. 2
Fig. 2
b. The hand at the beginning of the first surgery. b. The hand immediately after the first surgical decompression.
Fig. 3
Fig. 3
Tissue sample of myxomatous texture forming the abscess.
Fig. 4
Fig. 4
The hand on the 8th post-operative day.
See this image and copyright information in PMC

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