Diagnosis and Treatment for Deep Nontuberculous Mycobacteria Infection of the Hand and Wrist
| Autor: | Jae Youn Yoon, Ho Youn Park, Jun O Yoon, Jim Sam Kim, Jin Woong Park |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Tenosynovitis biology business.industry Osteomyelitis Skin ulcer Wrist medicine.disease biology.organism_classification Infective Arthritis Surgery body regions medicine.anatomical_structure medicine Ulnar deviation Nontuberculous mycobacteria medicine.symptom Range of motion business |
| Zdroj: | Journal of the Korean Society for Surgery of the Hand. 20:119 |
| ISSN: | 2234-0998 1598-3889 |
| DOI: | 10.12790/jkssh.2015.20.3.119 |
| Popis: | Purpose: The purpose of this study was to present a systematic treatment method for nontuberculous mycobacteria (NTM) infection of the hand and wrist to gain better clinical outcomes. Methods: 10 patients of deep NTM infection of the hand and wrist were reviewed. Extensive debridement was performed in all cases. When biopsy result suggested mycobacterial infection such as granulomatous inflammation, empirical tuberculosis medication was started. After culture confirmed NTM growth, the species was identified and in vitro sensitivity test was performed. Then medication was switched according to the results. Functional outcomes of the hand and wrist were measured by total active motion of the fingers and by range of motion of the wrist respectively. Results: Diagnosis was tenosynovitis in seven patients, infective arthritis and osteomyelitis combined with tenosynovitis of the wrist in three patients. Two patients had recurred skin ulcer during follow-up period and undergone second debridement. After second operation, no patient had a persistent discharging sinus and all patient were completely healed during follow-up period. Functional outcome of the eight patients who had NTM infection of their hand was excellent in two, good in four, fair in one, poor in one. Mean range of motion of the two patients who had osteomyelitis of their wrist was dorsiflexion 20°, volar flexion 15°, radial deviation 0°, ulnar deviation 15°. Conclusion: Our standardized treatment protocol can be helpful for treatment of deep NTM infection of the hand and wrist. |
| Databáze: | OpenAIRE |
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