Unusual presentation of carpal tunnel syndrome due toMycobacterium marinuminfection of hand

Abstract

We report a case of a fisherman presenting with a rare and unusual carpal tunnel syndrome due toMycobacterium marinuminfection of the hand and wrist. The infection resulted in severe pain, paresthesia and restriction of movement in the hand.Flexor tenosynovectomy, followed by histological and microbiological studies, indicated the presence of atypical mycobacteria. The patient was started on a combination antimicrobial therapy for 6 months. The patient regained full range of motion and returned to perform daily activities with ease.Diagnosis ofM. marinuminfection of the hand is challenging as the presentation mimics other conditions and may have nonspecific histological findings. This atypical mycobacterium may also show resistance to commonly used antitubercular drugs. Hand surgeons should maintain a high index of suspicion ofM. marinumand adopt a multiteam approach to prevent delay in diagnosis for successful treatment.