Mycobacterium szulgaiによる感染性腱鞘炎の1例

Mycobacterium szulgai tenosynovitis：a case report

Mycobacterium szulgai（M. szulgai）は非結核性抗酸菌であり，感染症の報告は少なく，多くは肺感染症で肺外病変はまれである。M. szulgaiが腱鞘炎の起因菌となった症例は検索範囲において我が国で3例，海外で9例のみであった。今回我々は，M. szulgaiによる感染性腱鞘炎を経験したので文献的考察を加えて報告する。

A woman in her 70s had been experiencing joint pain in her right hand for four years and was initially treated for rheumatoid arthritis. Due to a lack of response to the treatment, she was referred to our orthopedics department. She underwent a hand–joint puncture, and Mycobacterium szulgai（a rare, slow–growing non–tuberculous mycobacterium）was identified in the joint fluid culture. Her symptoms improved following treatment with a three–drug combination：ethambutol, rifampicin, and clarithromycin. The number of reported cases of M. szulgai infection is small, and the number of extrapulmonary M. szulgai lesions is even smaller. When unilateral chronic tendonitis or synovitis is observed, non–tuberculous mycobacterial infection should be considered as a differential diagnosis.