Knee Arthrodesis for Mycobacterium avium Complex Native-Knee Septic Arthritis in a Patient with Dermatomyositis

Jabbouri, Sahir; Halperin, Scott J.; Pathak, Neil; Wilhelm, Christopher V; Ng, Mitchell; Arsoy, Diren

doi:10.2106/jbjs.cc.22.00060

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…A combination of surgery and 6–12 months of active anti-MAC antibiotic therapy for osteoarticular MAC infection was recommend from a previous guideline. 3 Although further detailed recommendations regarding the PJI by MAC were not available from the previous guideline, 3 a prolonged course (12 months or more in severe infection 12 ) of anti-MAC antibiotic therapy is recommended, in addition to surgical intervention including debridement or surgical excision. 3 There is a lack of clear evidence suggesting that a shorter duration of antibiotic therapy would yield equally successful outcomes, and recurrence may occur even after the completion of long term combination therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The exclusion criteria were (1) articles without data on patient risk factors for infection (immunocompromising conditions), (2) assessment of any other joints beyond the realm of the hip and knee joint, 10 (3) non-English articles, (4) abstracts only, (5) conference presentations, and (6) native joint infection (septic arthritis) before arthroplasty. 11,12 Given the dearth of substantial evidence pertaining to this topic, our review predominantly encompasses case reports and case series to provide a comprehensive analysis. No limits for the minimum duration of follow-up for patient cohorts in each study were imposed.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Mycobacterium avium complex prosthetic joint infection: A systematic review of the literature and pooled analysis

Kim,

Lee,

Lee

et al. 2023

J Orthop Surg (Hong Kong)

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Background Mycobacterium avium complex (MAC) prosthetic joint infection (PJI) has been rarely reported. Methods This study aimed to investigate the epidemiology and outcomes of MAC PJI. A systematic review of the literature regarding the MAC infection following total joint arthroplasty including hip and knee joint was performed. Multiple databases were searched for published English-written articles up to May 2023. Studies that reported cases of PJI by MAC were reviewed. Results A total of 17 patients were identified and analyzed from 11 published studies. All patients presented with joint symptom of pain or swelling prior to the diagnosis and MAC was confirmed by culture. The most of the patients (16/17 patients, 94.1%) were noted to have underlying medical condition(s) that might have affected immunity. Treatment consisted of anti-MAC medication therapy only in two patients and anti-MAC medication therapy plus surgery in 15 patients. Among the patients who underwent surgery, 14 patients (82.3%) had removal of the prosthesis including seven patients who had two-stage surgery to have reimplantation of the prosthesis. No relapse of MAC infection was reported despite of one case of relapse of infection caused by different pyogenic bacteria. The rate of overall mortality was 29.4%, however, identified attributable mortality due to MAC infection was low (5.9%). Conclusion PJI by MAC is a rare disease. However, MAC needs to be considered in the differential diagnosis in immunocompromised patients presenting with symptoms of PJI. Two-stage exchange arthroplasty may result in successful treatment outcomes without higher risks of relapse of infection if undertaken in association with appropriate active anti-MAC antibiotic therapy.

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