A Cluster of Nontuberculous Mycobacterial Tenosynovitis Following Hurricane Relief Efforts.

Turner, Nicholas A; Sweeney, Mollie I; Xet-Mull, Ana M; Storm, Jeremy; Mithani, Suhail K; Jones, David B; Miles, Jeremy J; Tobin, David M; Stout, Jason E

A Cluster of Nontuberculous Mycobacterial Tenosynovitis Following Hurricane Relief Efforts.

dc.contributor.author	Turner, Nicholas A
dc.contributor.author	Sweeney, Mollie I
dc.contributor.author	Xet-Mull, Ana M
dc.contributor.author	Storm, Jeremy
dc.contributor.author	Mithani, Suhail K
dc.contributor.author	Jones, David B
dc.contributor.author	Miles, Jeremy J
dc.contributor.author	Tobin, David M
dc.contributor.author	Stout, Jason E
dc.date.accessioned	2022-04-12T20:11:59Z
dc.date.available	2022-04-12T20:11:59Z
dc.date.issued	2021-06
dc.date.updated	2022-04-12T20:11:58Z
dc.description.abstract	Background Nontuberculous mycobacteria (NTM) are a rare cause of infectious tenosynovitis of the upper extremity. Using molecular methods, clinical microbiology laboratories are increasingly reporting identification down to the species level. Improved methods for speciation are revealing new insights into the clinical and epidemiologic features of rare NTM infections. Methods We encountered 3 cases of epidemiologically linked upper extremity NTM tenosynovitis associated with exposure to hurricane-damaged wood. We conducted whole-genome sequencing to assess isolate relatedness followed by a literature review of NTM infections that involved the upper extremity. Results Despite shared epidemiologic risk, the cases were caused by 3 distinct organisms. Two cases were rare infections caused by closely related but distinct species within the Mycobacterium terrae complex that could not be differentiated by traditional methods. The third case was caused by Mycobacterium intracellulare. An updated literature review that focused on research that used modern molecular speciation methods found that several species within the M. terrae complex are increasingly reported as a cause of upper extremity tenosynovitis, often in association with environmental exposures. Conclusions These cases illustrate the importance of molecular methods for speciating phenotypically similar NTM, as well as the limitations of laboratory-based surveillance in detecting point-source outbreaks when the source is environmental and may involve multiple organisms.
dc.identifier	5951241
dc.identifier.issn	1058-4838
dc.identifier.issn	1537-6591
dc.identifier.uri	https://hdl.handle.net/10161/24793
dc.language	eng
dc.publisher	Oxford University Press (OUP)
dc.relation.ispartof	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
dc.relation.isversionof	10.1093/cid/ciaa1665
dc.subject	Humans
dc.subject	Mycobacterium avium Complex
dc.subject	Tenosynovitis
dc.subject	Cyclonic Storms
dc.subject	Mycobacterium Infections, Nontuberculous
dc.subject	Nontuberculous Mycobacteria
dc.title	A Cluster of Nontuberculous Mycobacterial Tenosynovitis Following Hurricane Relief Efforts.
dc.type	Journal article
duke.contributor.orcid	Turner, Nicholas A\|0000-0003-0650-4894
duke.contributor.orcid	Sweeney, Mollie I\|0000-0002-5297-1904
duke.contributor.orcid	Mithani, Suhail K\|0000-0002-3762-0831
duke.contributor.orcid	Tobin, David M\|0000-0003-3465-5518
duke.contributor.orcid	Stout, Jason E\|0000-0002-6698-8176
pubs.begin-page	e931
pubs.end-page	e937
pubs.issue	12
pubs.organisational-group	Duke
pubs.organisational-group	School of Medicine
pubs.organisational-group	Student
pubs.organisational-group	Basic Science Departments
pubs.organisational-group	Clinical Science Departments
pubs.organisational-group	Immunology
pubs.organisational-group	Molecular Genetics and Microbiology
pubs.organisational-group	Medicine
pubs.organisational-group	Orthopaedics
pubs.organisational-group	Surgery
pubs.organisational-group	Medicine, Infectious Diseases
pubs.organisational-group	Surgery, Plastic, Maxillofacial, and Oral Surgery
pubs.publication-status	Published
pubs.volume	72