Tenosynovitis Caused by Mycobacterium kansasii: A Case Report and Literature Review

We present a case of Mycobacterium kansasii tenosynovitis seen at Ramathibodi Hospital, Bangkok, Thailand. This 50-year-old Thai male without significant underlying disease presented with chronic tenosynovitis of the right middle and ring fingers. After experiencing failure of conservative treatment, the patient underwent surgery and surgical exploration demonstrated “rice bodies” in a region of chronic synovitis. A treatment with isoniazid, rifampicin, pyrazinamide, and ethambutol were then started. The tissue culture eventually grew M. kansasii. Non-tuberculous mycobacteria are not the common infectious causes of tenosynovitis and could be missed. An awareness of these pathogens and a confirmatory mycobacterial culture are crucial for the diagnosis. (J Infect Dis Antimicrob Agents 2007;24:143-8.)