rifampin and Hand-Injuries

Osteoarticular pathology in leprosy is common and described at all stages, but rarely as the most evident clinical manifestation. We report a case of borderline lepromatous leprosy with initial and disabling hands edema. The swollen hands syndrome is probably due to chronic Mycobacterium leprae tenosynovitis.

Topics: Adult; Anti-Bacterial Agents; Dapsone; Edema; Hand Injuries; Humans; Leprosy, Lepromatous; Male; Mycobacterium leprae; Rifampin; Syndrome; Synovitis

A significant number of patients infected with Mycobacterium marinum have been treated at the Curtis National Hand Center in Baltimore, Maryland. The purpose of this study was to review the authors' experience with M. marinum infections of the upper extremity. Twenty-nine patients were identified and their charts were reviewed for all factors related to diagnosis and treatment. The most common presenting symptoms were swelling (n = 25) and pain (n = 14). Only 69 percent of patients could correlate their injury with aquatic activities. The mean time from injury to diagnosis was 5.2 months. Acid-fast bacilli stains were positive in only 22 percent of specimens. The mean number of procedures was 1.75, with the majority being tenosynovectomy. The mean duration of antibiotic therapy was 6 months. Clinical history, pathological evaluation, and a high clinical suspicion can lead to early diagnosis and introduction of antibiotics. The authors' patients were successfully treated with 6 months of antibiotic therapy and early surgical intervention.

Topics: Adult; Aged; Anti-Bacterial Agents; Clarithromycin; Ethambutol; Female; Hand; Hand Injuries; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Retrospective Studies; Rifampin

Infection with Mycobacterium marinum is rare and usually produces cutaneous lesions. We report here two cases of tenosynovitis of abductor muscles.. The first case presented isolated involvement of the abductors of the left thumb, and the second the abductors of the middle finger. In both cases, the bacteriological examinations found M. marinum. Antibiotic therapy for three months with rifampin and clarithromycin cured the infection.. These cases of tenosynovitis followed deep inoculation. A mycobacterial infection should be considered in cases of synovitis, especially when limited to an area of the hand in patients without other rheumatic disorders.

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Clarithromycin; Female; Hand Injuries; Humans; Male; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Rifampin; Tenosynovitis; Time Factors; Treatment Outcome

Topics: Debridement; Ethambutol; Female; Hand Dermatoses; Hand Injuries; Humans; Inflammation; Male; Middle Aged; Mycobacterium; Mycobacterium Infections; Radiography; Rifampin; Synovectomy; Water Microbiology