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Case of flexor tenosynovitis caused by Mycobacterium arupense
  1. Kushali Patel1 and
  2. John Flaherty2
  1. 1College of William & Mary, Williamsburg, Virginia, USA
  2. 2Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
  1. Correspondence to Dr John Flaherty; j-flaherty4{at}


Mycobacterium arupense is a member of the Mycobacterium terrae complex (MTC) that is implicated in bone and joint infections, among others. This group of environmental pathogens can be found in soil, reclaimed and drinking water systems, rodents, fish tanks and bioaerosols in duck houses. Interestingly, while M. arupense is genotypically closely related to the other agents in the MTC, antibiotic susceptibility of these mycobacteria can vary widely and empiric antibiotic therapy is controversial. Our case report contributes to the very limited literature on M. arupense tenosynovitis—as only six cases have been reported since 2008—and sheds light on different courses of treatment. While previous cases have been successfully treated, a streamlined course of therapy for M. arupense tenosynovitis is still needed.

  • infections
  • infectious diseases
  • bone and joint infections
  • connective tissue disease

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  • Contributors KP and JF. We jointly planned this case report. KP completed the initial draft and we jointly edited and revised it. KP acquired the histopathologic images. JF obtained the radiologic imaging.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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