Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature

Background Chronic tenosynovitis of the upper extremities caused by Mycobacterium kansasii (M. kansasii) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment can lead to disfiguration of structures and rupture of tendons, resulting in worse cosmetic out...

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Main Authors: Maria T. Huayllani, Andrea Sisti, Daniel Boczar, David J. Restrepo, Alexander S. Parker, Rachel Sarabia-Estrada, Brian D. Rinker, Antonio Jorge Forte
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2020-03-01
Series:Indian Journal of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1709377
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author Maria T. Huayllani
Andrea Sisti
Daniel Boczar
David J. Restrepo
Alexander S. Parker
Rachel Sarabia-Estrada
Brian D. Rinker
Antonio Jorge Forte
author_facet Maria T. Huayllani
Andrea Sisti
Daniel Boczar
David J. Restrepo
Alexander S. Parker
Rachel Sarabia-Estrada
Brian D. Rinker
Antonio Jorge Forte
author_sort Maria T. Huayllani
collection DOAJ
description Background Chronic tenosynovitis of the upper extremities caused by Mycobacterium kansasii (M. kansasii) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment can lead to disfiguration of structures and rupture of tendons, resulting in worse cosmetic outcomes after reconstruction. Methods We present a clinical case and literature review of M. kansasii in patients with chronic tenosynovitis of upper extremities. PubMed was queried for cases of upper extremities tenosynovitis caused by M. kansasii. The keywords “M. kansasii,” “tenosynovitis” and synonyms were used for search in different combinations. Manuscripts, with no specific data or another condition, where the infection was not located in the upper extremities, were reviews, or not in English, were excluded from the study. Results We described 23 reported cases of tenosynovitis of the upper extremity caused by M. kansasii. An immunosuppressed state was present in eight (34.8%) cases, and 12 (52.2%) patients received immunosuppressive treatment. A long-time period between the first appearance of symptoms and the definitive diagnosis was identified (median: 7 months, interquartile range: 9). The most frequent symptoms were local swelling (65.2%), pain (56.5%), mass effect (26%), and stiffness (13%). Tendon rupture was found in three (13%) patients as a complication of the disease. Moreover, seven (30.4%) patients underwent previous surgeries to try to relieve the symptoms before definitive diagnosis was achieved. Conclusion M. kansasii is an important differential causal pathogen for tenosynovitis of the upper extremities. Although rare, raising awareness about this infectious disease is imperative to avoid inadequate management and hazardous aesthetic sequelae.
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spelling doaj-art-942ca1f532ab4ee188f5e9f3f7f68f3e2025-08-20T01:58:12ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2020-03-01530102503510.1055/s-0040-1709377Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of LiteratureMaria T. Huayllani0Andrea Sisti1Daniel Boczar2David J. Restrepo3Alexander S. Parker4Rachel Sarabia-Estrada5Brian D. Rinker6Antonio Jorge Forte7Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United StatesUniversity of Florida, College of Medicine, Jacksonville, Florida, United StatesDepartment of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United StatesDivision of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, United StatesBackground Chronic tenosynovitis of the upper extremities caused by Mycobacterium kansasii (M. kansasii) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment can lead to disfiguration of structures and rupture of tendons, resulting in worse cosmetic outcomes after reconstruction. Methods We present a clinical case and literature review of M. kansasii in patients with chronic tenosynovitis of upper extremities. PubMed was queried for cases of upper extremities tenosynovitis caused by M. kansasii. The keywords “M. kansasii,” “tenosynovitis” and synonyms were used for search in different combinations. Manuscripts, with no specific data or another condition, where the infection was not located in the upper extremities, were reviews, or not in English, were excluded from the study. Results We described 23 reported cases of tenosynovitis of the upper extremity caused by M. kansasii. An immunosuppressed state was present in eight (34.8%) cases, and 12 (52.2%) patients received immunosuppressive treatment. A long-time period between the first appearance of symptoms and the definitive diagnosis was identified (median: 7 months, interquartile range: 9). The most frequent symptoms were local swelling (65.2%), pain (56.5%), mass effect (26%), and stiffness (13%). Tendon rupture was found in three (13%) patients as a complication of the disease. Moreover, seven (30.4%) patients underwent previous surgeries to try to relieve the symptoms before definitive diagnosis was achieved. Conclusion M. kansasii is an important differential causal pathogen for tenosynovitis of the upper extremities. Although rare, raising awareness about this infectious disease is imperative to avoid inadequate management and hazardous aesthetic sequelae.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1709377chronic tenosynovitis mycobacterium kansasii characteristicscomplicationshandupper extremity
spellingShingle Maria T. Huayllani
Andrea Sisti
Daniel Boczar
David J. Restrepo
Alexander S. Parker
Rachel Sarabia-Estrada
Brian D. Rinker
Antonio Jorge Forte
Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature
Indian Journal of Plastic Surgery
chronic tenosynovitis
mycobacterium kansasii
characteristics
complications
hand
upper extremity
title Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature
title_full Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature
title_fullStr Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature
title_full_unstemmed Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature
title_short Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature
title_sort chronic tenosynovitis of the upper extremities caused by mycobacterium kansasii a clinical case and systematic review of literature
topic chronic tenosynovitis
mycobacterium kansasii
characteristics
complications
hand
upper extremity
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1709377
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