Houston Methodist. Leading Medicine

Hand FAQ

Question:

I went up to Alaska to seek fame and fortune. I found both. First the fortune -- it was a great paying job (shelling shrimp). Now the fame: I developed a rare hand infection from something called mycobacterium abscessus. I'm all better now after surgery. I'd like to get back on the job but my surgeon says I need hand therapy. What could happen if I skipped that step?

Answer:

Men and women who handle fish (fresh or frozen) with their bare hands are at risk for hand infections. Usually, the type of bacteria present is mycobacterium marinum. Exposure to this type of bacteria (leading to hand infection) is common with exposure to fish. There is a less common (actually rare) bacteria among fish handlers that can also cause infection and even death of the affected soft tissues. Early diagnosis and aggressive treatment may be needed to prevent the rapid spread of infection and damage to the tissues caused by mycobacterium abscessus. Surgery is done to open up the hand, drain the infection, clean the area out, and provide the most effective antibiotics. Together, this combination of treatment is essential to a good outcome for these patients. Hand therapy after surgery is needed to prevent stiffness and assure smooth return of full finger motion and hand function. The therapist (either a physical or occupational therapist) may provide a special gutter splint to help maintain finger range-of-motion. The splint helps prevent the loss of finger extension (and subsequent curling of the fingers into flexion). Without full finger motion, hand function can be severely affected. Since your job probably involves fine dexterity of the hands (and also keeps your hands in a flexed position much of the time), hand therapy is an excellent idea. Your surgeon and your therapist will be able to advise you about specific dates for returning to work. Following your home program may help ensure a faster recovery. Gavin C. W. Kang, MD, et al. Mycobacterium abscessus Hand Infections in Immunocompetent Fish Handlers: Case Report. In Journal of Hand Surgery. July 2010. Vol. 35-A. No. 7. Pp. 1142-1145.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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