Infectious Tenosynovitis of the Tibialis Anterior Due to Mycobacterium chelonae After Intravenous Heroin Injection

J Foot Ankle Surg. 2020 Mar-Apr;59(2):413-417. doi: 10.1053/j.jfas.2019.08.017.

Abstract

Mycobacterium chelonae is a ubiquitous Gram-positive, acid-fast, non-spore-forming bacterium commonly encountered in nature associated with aquatic animals, soil, and water, including tap water. Nontuberculous mycobacterial tenosynovitis infections caused by M. chelonae in the lower extremity are uncommon, leading to a paucity of literature documenting the diagnosis and treatment of such cases. This report is of a 65-year-old male patient who was found to have an M. chelonae infection along the tibialis anterior tendon after injecting himself with heroin into the dorsal foot veins. This review covers the diagnosis and treatment as well as a case report on the outcome of infectious tenosynovitis of the tibialis anterior associated with M. chelonae. To date, this is the only reported case of tibialis anterior infectious tenosynovitis caused by M. chelonae after intravenous heroin injection.

Keywords: IV heroin; Mycobacterium chelonae; tenosynovitis; tibialis anterior.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Heroin / administration & dosage
  • Heroin / adverse effects*
  • Humans
  • Injections, Intravenous
  • Male
  • Mycobacterium Infections, Nontuberculous / diagnosis
  • Mycobacterium Infections, Nontuberculous / etiology*
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Mycobacterium chelonae / isolation & purification*
  • Narcotic-Related Disorders / complications*
  • Tenosynovitis / diagnosis
  • Tenosynovitis / etiology*
  • Tenosynovitis / microbiology
  • Tibia

Substances

  • Heroin