gms | German Medical Science

Objectives/Interrogation: Retrospectively analyze 7 patients diagnosed with CTS caused by NTM infection and explore the clinical character, differential diagnosis and corresponding treatment.

Methods: From June 2015 to June 2017, we collected 7 cases diagnosed with CTS, which during operation, we found granulomas inflammation and send for culture with NTM positive. We then retrospectively analyzed their etiology, clinical character, differential diagnosis, culture results, treatment and prognosis.

Results and Conclusions: 3 of 7 cases had a history of sea creature injury, while 4 cases had not. Clinical presented with numbness and pain, 5 cases had experience acute pain. 4 patients manifested with infectious redness and edema in the fingers while the other 3 patients had no infection signs. The culture showed mycobacterial marinum in 6 cases, in 1 case. EMG showed median nerve moderately compressed for 5 cases, severe for 2 cases. 4 patients took antimycobacterial medication before operation, we did CTR and thorough debridement for 4 patients, and CTR and limit debridement. All the patients get pain relief and numbness improved. All the patients were prescribed with antimycobacterial medication for an average of 2.5 months. 6 of them recovered uneventfully with satisfied function, 1 patient who underwent limited debridement reoccured in 2 months after surgery who need another thorough debridement and recovered with mild dysfunction.

NTM infection can present with CTS which is difficult to differenciate. Acute and continued pain indicate the present of infection. The main treatment is antimycobacterial medication. Debridement and CTR surgery is for those with obvious nerve compression syndrome while can not relief after conservative treatment.