Pyogenic tenosynovitis of the wrist due to Corynebacterium striatum in a patient with dermatomyositis: A case report

Medicine (Baltimore). 2020 Jan;99(3):e18761. doi: 10.1097/MD.0000000000018761.

Abstract

Introduction: Corynebacterium striatum is common contaminant in clinical specimens. Here, we report a rare case of pyogenic tenosynovitis of the wrist caused by C striatum in a dermatomyositis patient taking oral immunosuppressants.

Patient concerns: A 67-year-old Japanese woman with dermatomyositis had a history of multiple intraarticular injections of corticosteroids to the right wrist joint for the treatment of osteoarthritis. She was admitted to our hospital with a painful lump on the right dorsal wrist lasting for three months. MRI revealed cellulitis of the dorsum of the right wrist and hand and fluid collection in the extensor tendon sheath. C striatum was detected in the cultures of three samples of synovial fluid taken from the dorsal hand.

Diagnosis: Pyogenic tenosynovitis of the wrist due to C striatum.

Interventions: The infection was successfully controlled with synovectomy and adjuvant antibiotic therapy.

Outcomes: There has been no sign of recurrence for 12-months after the surgical treatment.

Lessons: This is the first reported case of pyogenic tenosynovitis due to C striatum in a patient with dermatomyositis. Clinicians should be aware that patients undergoing immunosuppressive therapy have a risk of C striatum infection.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Corynebacterium Infections / microbiology*
  • Corynebacterium Infections / therapy
  • Corynebacterium*
  • Dermatomyositis / drug therapy
  • Dermatomyositis / microbiology*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Tenosynovitis / microbiology*
  • Tenosynovitis / therapy

Substances

  • Immunosuppressive Agents

Supplementary concepts

  • Corynebacterium striatum