Mycobacterium abscessus Hand Infection Mimicking Dactylitis Due to Spondyloarthritis: A Case Report

<i>Mycobacterium abscessus </i>is an environmental, rapid-growing non-tuberculosis <i>Mycobacterium</i> commonly found in soil and water. While typically causing pulmonary infections, it can present with musculoskeletal manifestations that mimic inflammatory arthritis. We present a case of a 73-year-old woman who developed progressive hand tenosynovitis following a gardening injury. The clinical presentation initially suggested seronegative spondyloarthritis, particularly due to the presence of dactylitis. However, synovial biopsy and culture ultimately revealed <i>M. abscessus </i>subsp. <i>abscessus </i>infection. This case highlights the importance of considering atypical infections in the differential diagnosis of apparent inflammatory arthritis, especially with unilateral involvement and inadequate response to conventional therapy.