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Unusual presentation of carpal tunnel syndrome due to Mycobacterium marinum infection of hand
  1. Mithun Pai G,
  2. Anil K Bhat,
  3. Ashwath M Acharya and
  4. Shreya Pulli Reddy
  1. Department of Hand surgery, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
  1. Correspondence to Dr Anil K Bhat; anilkbhat{at}


We report a case of a fisherman presenting with a rare and unusual carpal tunnel syndrome due to Mycobacterium marinum infection 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 of M. marinum infection 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 of M. marinum and adopt a multiteam approach to prevent delay in diagnosis for successful treatment.

  • Exposures
  • Infections
  • Pain

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  • Contributors MP: manuscript writing. AKB: concept, editing, reviewing. AA: concept, editing, reviewing. SPR: manuscript writing.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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