Increasing Recognition of Community-Acquired, Non-Tuberculous Mycobacterial Infections of the Hand and Wrist.

Autor: Ricci J; Surgery, Medical University of South Carolina, Charleston, USA., Jones P; Surgery, Medical University of South Carolina, Charleston, USA., Le A; College of Medicine, Medical University of South Carolina, Charleston, USA., Steed LL; Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, USA., Armstrong MB; Plastic and Reconstructive Surgery, Medical University of South Carolina, Charleston, USA., Herrera FA; Plastic and Reconstructive Surgery, Medical University of South Carolina, Charleston, USA.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2022 Feb 10; Vol. 14 (2), pp. e22105. Date of Electronic Publication: 2022 Feb 10 (Print Publication: 2022).
DOI: 10.7759/cureus.22105
Abstrakt: Background In this study, we present our experience with community-acquired, culture-positive, non-tuberculous mycobacterial (NTM) infections of the hand and wrist and compare the clinical features, risk factors, diagnostic delays, and treatment outcomes among patients referred for surgical consultation at our institution over a five-year period. Methodology We retrospectively identified patients on chart review who were diagnosed with culture-positive, extrapulmonary, cutaneous NTM infections between January 1, 2014, and December 31, 2018. Only patients with community-acquired NTM infections of the hand and wrist were included. Patient demographics, risk factors, location, diagnostic delays, NTM species isolated, treatment modalities, and treatment outcomes were collected and analyzed. These variables were further compared between patients who participated in fishing-related activities and those who did not. Results A total of 10 patients were identified with community-acquired NTM infections of the hand or wrist. Of these patients, eight (80%) were male, and six (60%) had participated in fishing-related activities prior to the initial presentation. The majority of patients had Mycobacterium marinum isolates (n = 6, 60%) and involved the hand (n = 8, 80%).  M. marinum isolates were associated with a significantly shorter time to diagnosis (p = 0.02). All patients underwent surgical management with a prolonged course of postoperative antibiotics and were cured of their infection at the end of their treatment course. Conclusions Proper risk factor documentation and heightened clinical awareness are essential to reduce delays in the diagnosis of NTM skin and soft tissue infections and provide the best chance for curative therapy.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2022, Ricci et al.)
Databáze: MEDLINE