Unusual swelling of the hand and multiple nodules over the body – beware of mycobacteria

Atypical mycobacteria can cause rare and atypical infections of the hand. We report the case of an immunocompetent 46-year-old male initially presenting with thumb felon and progressively developing symptoms of carpal tunnel syndrome, tenosynovitis of multiple fingers and a sporotrichoid lymphocutaneous infection causing chronic cutaneous lesions all over the body. We would like to highlight the diagnostic and therapeutic difficulties of these atypical infections, which mimic other conditions and can cause a lot of morbidity.