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

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.