Atypical mycobacterial flexor tenosynovitis presenting as carpal tunnel syndrome: Presentation of three cases and review

Abstract

Three patients with carpal tunnel syndrome secondary to atypical mycobacteria flexor tenosynovitis are presented. Aggressive surgical debridement combined with long term antitubercular pharmacotherapy resulted in a good outcome, but the lag time to diagnosis and course of disease were long. Diagnosis of these infections requires a high suspicion index, adequate surgical biopsy and appropriate cultures. Atypical mycobacteria infections must be considered in the differential diagnosis in any patient with evolving chronic tenosynovitis, even if the patient has no history of immunosuppression, and especially if environmental risk factors are present.