Chronic osteomyelitis of the hand by Mycobacterium kansasii in an immunocompromised patient

Authors

  • Jorge Adrián Garza Cerna Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico http://orcid.org/0000-0001-8387-2637
  • Raúl Omar Martínez Zarazúa Department of General Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico
  • Everardo Valdes Flores Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico
  • M. Mauricio Manuel Perez García Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico
  • Gabriel Angel Mecott Rivera Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico

DOI:

https://doi.org/10.18203/2349-2902.isj20214385

Keywords:

Hand osteomyelitis, Non-tuberculous Mycobacterium, Immunocompromised

Abstract

Atypical mycobacteria are pathogens that uncommonly infect the hand. These organisms are capable of causing extensive bone damage in the hand. Mycobacterium kansasii is a slow growing non-tuberculous Mycobacterium. It is the second most common non-tuberculous Mycobacterium that mainly affects the hand and joints. Immunosuppressed patients are more likely to develop infection. Because extrapulmonary involvement of M. kansasii is rare, skin and soft tissue infections are infrequent; osteomyelitis is even rarer. Immunosuppressed patients are more likely to develop infection. A history of trauma is frequent. There is a delay in diagnosis antibiotics have been given with no response. Imaging studies are recommended in the diagnostic approach, with magnetic resonance imaging being the best option to show bone and soft tissue involvement. Infected tissue culture has greater sensitivity for diagnosis. Treatment for musculoskeletal involvement consists of multiple susceptibility-based antibiotics and antiretroviral therapy in HIV coinfection, combined with surgical management with incision and drainage.

Author Biographies

Jorge Adrián Garza Cerna, Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico

Residente Cirugía General, Hospital Universitario de Nuevo León

Raúl Omar Martínez Zarazúa, Department of General Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico

Residente Cirugía Plástica Hospital Universitario de Nuevo León

Everardo Valdes Flores, Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico

Profesor adscrito Cirugía Plástica Hospital Universitario de Nuevo León

M. Mauricio Manuel Perez García, Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico

Jefe de departamento Cirugía Plástica Hospital Universitario de Nuevo León

Gabriel Angel Mecott Rivera, Department of Plastic Surgery, Nuevo León University Hospital, Monterrey, Nuevo León, Mexico

Profesor adscrito Cirugía Plástica Hospital Universitario de Nuevo León

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Published

2021-10-28

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Case Reports