Bringing the heat to non-tuberculous mycobacterial infections: a comprehensive review inspired by a striking case of successful treatment

Q3 Medicine

Clinical Infection in Practice Pub Date : 2025-08-01 DOI:10.1016/j.clinpr.2025.100503

Marisa B. Kaelin , Lukas A. Walker , Vera Ihle , Lisa Jungblut , Martina Greminger , Bettina Schulthess , Johannes Nemeth

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Abstract

The incidence of extrapulmonary non-tuberculous mycobacterial (NTM) infections is increasing globally, particularly among immunosuppressed patients. These infections are notoriously difficult to treat and often require long-term multidrug therapy leading to significant side effects. Although anecdotal evidence supports thermal therapy as beneficial, it remains underutilized and absent from treatment guidelines.

We present a case of chronic tenosynovitis and osteomyelitis in the index finger caused by Mycobacterium chelonae, where the patient showed minimal recovery with surgery and antibiotics but experienced rapid improvement after starting local thermal therapy.

Our literature review reveals multiple case reports supporting thermal therapy in treating NTM infections. Given the observed benefits and low toxicity, we recommend further exploration and incorporation of thermal therapy as a potential adjunct in the management of infections with heat-sensitive NTM.

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将热带到非结核分枝杆菌感染：一个全面的审查启发了一个引人注目的成功治疗的情况

肺外非结核分枝杆菌（NTM）感染的发病率正在全球范围内增加，特别是在免疫抑制患者中。众所周知，这些感染很难治疗，往往需要长期的多种药物治疗，导致严重的副作用。尽管坊间证据支持热疗是有益的，但它仍然没有得到充分利用，也没有出现在治疗指南中。我们报告一例由龟分枝杆菌引起的食指慢性腱鞘炎和骨髓炎，患者在手术和抗生素治疗后恢复很小，但在开始局部热疗后迅速改善。我们的文献回顾显示了多个病例报告支持热疗法治疗NTM感染。鉴于观察到的益处和低毒性，我们建议进一步探索和结合热疗法作为热敏性NTM感染管理的潜在辅助手段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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