{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:43:51Z","timestamp":1792107831300,"version":"4.4.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Mycobacterium malmoense is a slow-growing nontuberculous mycobacterium (NTM) increasingly recognized as a cause of extrapulmonary infections. Tenosynovitis due to M. malmoense is rare and diagnostically challenging because of its indolent course and nonspecific clinical presentation.<\/jats:p>\n                  <jats:p>We report a 65-year-old immunocompetent woman presenting with progressive wrist pain, swelling, and impaired hand function without prior trauma. Symptoms developed after exposure to fresh fish and shellfish. Surgical exploration revealed extensive tenosynovitis with median nerve compression. Histopathology showed granulomatous synovitis suggestive of mycobacterial infection. Molecular testing detected Mycobacterium genus DNA, while PCR for the Mycobacterium tuberculosis complex was negative. After prolonged incubation, culture identified M. malmoense. Drug susceptibility testing demonstrated susceptibility to standard antimycobacterial agents except doxycycline. Initial empiric therapy targeting M. marinum was adapted following species identification. After 8 months of treatment, significant clinical and radiological improvement was observed, with no evidence of relapse at 6-month follow-up.<\/jats:p>\n                  <jats:p>M. malmoense tenosynovitis is extremely rare, with only  few cases reported. Diagnosis is frequently delayed due to low sensitivity of microscopy, slow growth in culture, and nonspecific findings. Molecular diagnostics and prolonged incubation are essential. Management requires a combination of surgery and prolonged antimycobacterial therapy.<\/jats:p>\n                  <jats:p>NTM infections, including M. malmoense, should be considered in chronic tenosynovitis unresponsive to standard treatment. Early diagnostic suspicion and interdisciplinary management are crucial for favorable outcomes.<\/jats:p>","DOI":"10.1055\/a-2965-2426","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:45:43Z","timestamp":1792104343000},"source":"Crossref","is-referenced-by-count":0,"title":["Tenosynovitis caused by Mycobacterium malmoense"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4618-9115","authenticated-orcid":false,"given":"Manuel Vincent","family":"Peterka","sequence":"additional","affiliation":[{"name":"Helios Klinikum Emil von Behring Berlin-Zehlendorf, Germany","place":["Berlin"],"department":["Klinik f\u00fcr Pneumologie, Lungenklinik Heckeshorn"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Polsfuss","sequence":"additional","affiliation":[{"name":"Helios Hospital Emil von Behring Berlin-Zehlendorf, Germany","place":["Berlin"],"department":["Institute for Microbiology, Immunology and Laboratory Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1275-7361","authenticated-orcid":false,"given":"Torsten","family":"Bauer","sequence":"additional","affiliation":[{"name":"Helios Klinikum Emil von Behring Berlin-Zehlendorf, Germany","place":["Berlin"],"department":["Klinik f\u00fcr Pneumologie, Lungenklinik Heckeshorn"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Schoenfeld","sequence":"additional","affiliation":[{"name":"Helios Klinikum Emil von Behring Berlin-Zehlendorf, Germany","place":["Berlin"],"department":["Klinik f\u00fcr Pneumologie, Lungenklinik Heckeshorn"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"106203","DOI":"10.1016\/j.jinf.2024.106203","article-title":"Clinical spectrum and relevance of Mycobacterium malmoense: systematic review and meta-analysis of 859 patients","volume":"89","author":"N Wetzstein","year":"2024","journal-title":"J Infect"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12810","article-title":"Tenosynovitis caused by Mycobacterium malmoense in two kidney transplant recipients and review of the literature","volume":"20","author":"R van Grootveld","year":"2018","journal-title":"Transpl Infect Dis"},{"key":"ref3","first-page":"987","article-title":"The rising incidence and clinical relevance of Mycobacterium malmoense: a review of the literature","volume":"12","author":"W Hoefsloot","year":"2008","journal-title":"Int J Tuberc Lung Dis"},{"key":"ref4","first-page":"430","article-title":"Susceptibilities of Mycobacterium malmoense determined at the growth optimum pH (pH 6.0)","volume":"2","author":"ML Heginbothom","year":"1998","journal-title":"Int J Tuberc Lung Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e178","DOI":"10.1016\/S1473-3099(21)00586-7","article-title":"Consensus management recommendations for less common non-tuberculous mycobacterial pulmonary diseases","volume":"22","author":"C Lange","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1080\/00365549950163482","article-title":"Non-tuberculous mycobacterial tenosynovitis: a review","volume":"31","author":"T Zenone","year":"1999","journal-title":"Scand J Infect Dis"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2882","DOI":"10.1128\/jcm.31.11.2882-2889.1993","article-title":"Genotypic identification of mycobacteria by nucleic acid sequence determination: report of a 2-year experience in a clinical laboratory","volume":"31","author":"P Kirschner","year":"1993","journal-title":"J Clin Microbiol"},{"key":"ref8","volume-title":"Performance standards for susceptibility testing of Mycobacteria, Nocardia spp., and other aerobic actinomycetes. 1st ed. CLSI document M62","author":"Clinical and Laboratory Standards Institute","year":"2018"},{"key":"ref9","volume-title":"Susceptibility testing of Mycobacteria, Nocardia spp., and other aerobic actinomycetes. 2nd ed. CLSI supplement M24S Ed2","author":"Clinical and Laboratory Standards Institute","year":"2023"},{"key":"ref10","first-page":"283","article-title":"Non-tuberculous mycobacterial infections of the hand and wrist: a retrospective review of five cases from a single centre","volume":"41","author":"I Krusche-Mandl","year":"2009","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"783","DOI":"10.5858\/2006-130-783-MSCBSN","article-title":"Mycobacterial synovitis caused by slow-growing nonchromogenic species: eighteen cases and a review of the literature","volume":"130","author":"RJ Olsen","year":"2006","journal-title":"Arch Pathol Lab Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1016\/s0140-6736(89)92426-4","article-title":"Missed diagnosis of mycobacterial infection","volume":"1","author":"RA Elston","year":"1989","journal-title":"Lancet"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1016\/S0363-5023(97)80174-8","article-title":"Flexor tenosynovitis in the hand caused by Mycobacterium malmoense: a case report","volume":"22","author":"M Gabl","year":"1997","journal-title":"J Hand Surg Am"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/ajcp\/aqz125.000","article-title":"Comparison of acid-fast stain and auramine rhodamine fluorescent smear on bronchoalveolar lavage specimens submitted for cytologic examination","volume":"152","author":"H Samra","year":"2019","journal-title":"Am J Clin Pathol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3390\/diseases14030099","article-title":"Autoimmune diseases and mycobacterial infection","volume":"14(3)","author":"A Chorbajian","year":"2026","journal-title":"Diseases"},{"key":"ref16","doi-asserted-by":"crossref","DOI":"10.1183\/2312508X.10005716","volume-title":"Perspectives on antibiotic treatment of NTM pulmonary disease. In: Aliberti S, Chalmers JD, Pletz MW, eds. Anti-infectives and the Lung (ERS Monograph)","author":"N Sch\u00f6nfeld","year":"2017"}],"container-title":["Pneumologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2965-2426.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:45:45Z","timestamp":1792104345000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2965-2426"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":16,"URL":"https:\/\/doi.org\/10.1055\/a-2965-2426","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0934-8387","1438-8790"],"issn-type":[{"value":"0934-8387","type":"print"},{"value":"1438-8790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]}}}