Three cases of successful treatment of granulomatous tenosynovitis

Jui-Teng Chien^{a, b}, Fu-Tsung Hsiao^c, Yu-Chuan Chen^d, Yu-Hong Chen^b, Chorng-Jang Lay^{b, e}, Chen-Chi Tsai^{b, e}

^a Department of Orthopedics, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^b School of Medicine, Tzu Chi University, Hualien, Taiwan
^c Department of Radiology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
^d Department of Clinical Pathology, Buddhist Dalin Tzu Chi General Hospital, Chiayi Taiwan
^e Division of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan

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Abstract
Granulomatous tenosynovitis is a rare disease with an indolent, relapsing process, which can be caused by various pathogens. Here, we describe three immunocompetent patients with right wrist granulomatous tenosynovitis. Two cases were attributed to nontuberculous mycobacteria (NTM) infection. In the third case, no definite etiology was found. However, the symptoms and patient history were similar to the other two cases. All three patients were cured by surgical debridement and clarithromycin-based anti-NTM antibiotics.

Keywords
Granuloma; Mycobacterium; Tenosynovitis