The carpal tunnel syndrome caused by Arthrinium phaeospermum infection: first case report and literature review.

BACKGROUND

The carpal tunnel syndrome (CTS) caused by atypical infection is a therapeutic and diagnostic challenge. Atypical clinical presentations often lead to misdiagnosis and incorrect therapy.

CASE PRESENTATION: This article reports a case of deep infection leading to CTS manifestations. A male patient was admitted for numbness and pain of the left hand. Left carpal tunnel release, median nerve decompression with synovial resection were performed. Inflamed synovium and effusion were submitted for bacterial culture and metagenomic next-generation sequencing (mNGS). The etiologic agent was identified as Arthrinium phaeospermum and the patient recovered after surgical debridement and 10 months of therapy.

CONCLUSIONS

Diagnosis of mycotic infection of the hand is challenging as the presentation is similar to other conditions. mNGS is presented as a valuable diagnostic adjunct for uncovering unusual infectious agents.