Atypical mycobacterium soft-tissue infection of the dorsal radial wrist: a possible complication of steroid injection for de Quervain's disease.

Corticosteroid injection into the first dorsal compartment for acute de Quervain's tenosynovitis is an accepted form of therapy. Potential side effects include soft-tissue atrophy, tendon attrition, postinjection neuritis of the superficial radial nerve, systemic reactions, and infection. We present a patient with a Mycobacterium chelonei infection localized to the soft tissue overlying the first dorsal compartment, occurring 3 years after a triamcinolone injection into this area. Histological examination with the polarizing microscope revealed persistent steroid granules in the involved tissue. Successful treatment consisted of complete excision of the involved skin and subcutaneous tissue followed by delayed closure. Systemic antibiotics were not used.