<i>Mycobacterium kansasii</i> tenosynovitis in a rheumatoid arthritis patient with long‐term therapeutic immunosuppression

Lorenz, Hanns‐Martin; Dalpke, Alexander H.; Deboben, A.; Ho, Anthony D.; Greiner, Andreas; Jung, Martin; Fiehn, Christoph

doi:10.1002/art.23717

Cited by 13 publications

(13 citation statements)

References 15 publications

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“…Various slow and fast growing mycobacteria have been isolated with Mycobacterium marinum (fish tank finger) and Mycobacterium kansasii being the most frequent causes of NTM tenosynovitis (3, 9). Less frequently, M. avium complex , M. szulgai , M. terrae , M. fortuitum , M. chelonae , M. abscessus , M. malmoense and M. xenopi are found (1, 3).…”

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

et al. 2011

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“…1,[9][10][11][12][13][14][15] The median of the time period between the first appearing of symptoms and the definitive diagnosis was 7 months (interquartile range: 9, range: 2-48). The most frequent symptoms were local swelling (65.2%), 1,6,8,[10][11][12][13][14][16][17][18][19] pain (56.5%), 1,6,7,9,10,12,15,[18][19][20] mass effect (26%), 5,9,12,13,15 and stiffness (13%). 7,9 Twelve (52.2%) patients received an initial immunosuppressive therapy.…”

Section: Resultsmentioning

confidence: 99%

“…7,9 Twelve (52.2%) patients received an initial immunosuppressive therapy. 131,[6][7][8]13,[18][19][20] Two (8.7%) of these patients received this treatment due to similar presentation to their previous RA disease 1,13 and one (4.3%) due to previous episodes of joints pain. 19 Other immunosuppressive medical conditions included polymyositis, 9 diabetes mellitus, 10,12 scleroderma, 11 kidney transplantation, 1,15 and rheumatic polymyalgia.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding treatment, seven (30.4%) patients underwent previous surgeries before definitive diagnosis to try to relieve the symptoms. 6,7,10,12,13,19 Antibiotic therapy was given in all cases, with the most common regimen being rifampin, ethambutol, isoniazid, and pyridoxine for long time periods (mean: 13.27 months, range: 1-24) to avoid recurrence of the disease. Resistance to isoniazid was found in two patients, 10,19 two patients stopped treatment due to adverse effects to ethambutol, 14,16 one to rifampin, 6 and one to clarithromycin.…”

Section: Resultsmentioning

confidence: 99%

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Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature

Huayllani

Sisti

Boczar

et al. 2020

Indian J Plast Surg

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Background Chronic tenosynovitis of the upper extremities caused by Mycobacterium kansasii (M. kansasii) is uncommon, but symptoms may overlap with other more common diseases. Late diagnosis and treatment can lead to disfiguration of structures and rupture of tendons, resulting in worse cosmetic outcomes after reconstruction. Methods We present a clinical case and literature review of M. kansasii in patients with chronic tenosynovitis of upper extremities. PubMed was queried for cases of upper extremities tenosynovitis caused by M. kansasii. The keywords “M. kansasii,” “tenosynovitis” and synonyms were used for search in different combinations. Manuscripts, with no specific data or another condition, where the infection was not located in the upper extremities, were reviews, or not in English, were excluded from the study. Results We described 23 reported cases of tenosynovitis of the upper extremity caused by M. kansasii. An immunosuppressed state was present in eight (34.8%) cases, and 12 (52.2%) patients received immunosuppressive treatment. A long-time period between the first appearance of symptoms and the definitive diagnosis was identified (median: 7 months, interquartile range: 9). The most frequent symptoms were local swelling (65.2%), pain (56.5%), mass effect (26%), and stiffness (13%). Tendon rupture was found in three (13%) patients as a complication of the disease. Moreover, seven (30.4%) patients underwent previous surgeries to try to relieve the symptoms before definitive diagnosis was achieved. Conclusion M. kansasii is an important differential causal pathogen for tenosynovitis of the upper extremities. Although rare, raising awareness about this infectious disease is imperative to avoid inadequate management and hazardous aesthetic sequelae.

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“…9 The causes of an isolated, progressive tenosynovitis include sarcoidosis, rheumatoid arthritis, tuberculosis, and other infections, including atypical mycobacteria. 10,11 Histologic examination and culture would be required to definitively determine the cause.…”

Section: Discussionmentioning

confidence: 99%

Rapid Development of Sarcoid Tenosynovitis

Lambert¹,

Riemer²,

Judson³

2011

JCR: Journal of Clinical Rheumatology

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We report a case of acute tenosynovitis from sarcoidosis and review previously reported cases of this entity. A woman with known pulmonary sarcoidosis rapidly developed painless nodules in the tendon sheaths of the dorsum of both hands and wrists. Sarcoid tenosynovitis is almost exclusively found in the upper extremity. The flexor and extensor tendons are equally affected. The condition may respond to medical therapy including corticosteroids and other immunomodulating medications. Surgical debulking and tendon sheathectomy have also been curative. The disease has also been reported to spontaneously resolve. Our patient dramatically improved while on methotrexate.

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Mycobacterium kansasii tenosynovitis in a rheumatoid arthritis patient with long‐term therapeutic immunosuppression

Cited by 13 publications

References 15 publications

Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

Nontuberculous Mycobacterial Tenosynovitis in the Hand: Two Case Reports with the MR Imaging Findings

Chronic Tenosynovitis of the Upper Extremities Caused by Mycobacterium kansasii: A Clinical Case and Systematic Review of Literature

Rapid Development of Sarcoid Tenosynovitis

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