Mycobacterium chelonae Wrist Infection in an Immunocompetent Patient

We report a 48-year-old Chinese immunocompetent female who presented with right wrist pain and swelling for 9 months because of Mycobacterium chelonae infection of her right wrist. M. chelonae infection has been increasingly reported. Immunocompromised patients are at increased risk of developing such an infection, however, this occasionally occurs in immunocompetent patients. M. chelonae infection more commonly causes cutaneous or soft tissue infection; however, in our case, we found that the infection was so severe that the infective tenosynovial tissue from the volar side of the wrist had eroded through both the volar and dorsal cortex of the distal radius. To our knowledge, wrist tenosynovitis with osteomyelitis of the distal radius caused by M. chelonae is rarely reported, especially in an immunocompetent nontraumatic individual. We successfully treated this patient by repeated surgical debridement using different approaches, appropriate antibiotics, as well as application of antibiotic-loaded cement to fill the bone defect.