伸筋腱断裂をきたした非結核性抗酸菌症の 1 例

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  • A Case of Nontuberculous Mycobacteriosis with Ruptures of the Extensor Tendons of the Hand

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An 88-year-old man presented with a history of swelling on the dorsal side of the hand without systemic illness. No skin lesions were present. Although he denied any specific injury, he reported that he had been stung on the hand by a bee one year previously. MR imaging with and without gadolinium enhancement showed marked extensor tenosynovitis but no bone erosions. Radiographs of the chest and hand revealed no abnormality. The patient subsequently underwent complete extensor tenosynovectomy of the hand. During surgery, the extensor digitorum communis IV and V tendons were found to be ruptured. Reconstruction of the extensor tendons using the palmaris longus tendon was performed. Pathological examination showed non-caseating granulomas with epithelioid cells, and Mycobacterium intracellulare was identified on culture. The patient was treated with rifampicin, ethambutol and clarithromycin for six months, and at the 12-month follow-up had achieved satisfactory extension of the finger with complete resolution of the soft tissue swelling of the hand.

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