Septic Arthritis in the Knee Due to Mycobacterium xenopi in a Patient Undergoing Hemodialysis

Kelly, Mirabelle; Thibert, Louise; Sinave, Christian

doi:10.1086/313447

Cited by 12 publications

(4 citation statements)

References 6 publications

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“…Cases of bone and joint infection associated with slowly growing mycobacteria have also been reported [150,151]. Chronic renal failure has been identified as a possible risk factor for NTM disease in retrospective cohort studies and literature reviews [23,134,152].…”

Section: Diabetes Mellitusmentioning

confidence: 99%

Susceptibility to nontuberculous mycobacterial lung disease: Table 1—

Sexton¹,

Harrison²

2008

Eur Respir J

143

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The nontuberculous mycobacteria (NTM) exhibit heterogeneous pathogenicity in humans. Articles on known and potential human factors capable of producing susceptibility to NTM lung disease (NTMLD) were identified by a systematic search of the medical literature, and are reviewed in the present study.Patients with pre-existing structural lung disease are known to be at risk of NTMLD. Other susceptible groups have become recognised since the 1980s, in particular middle-aged nonsmokers without previous lung disease (a group including those with Lady Windermere syndrome) and patients with genetically determined defects of cell-mediated immunity, including abnormalities of the interleukin-12/interferon-c axis, certain human leukocyte antigen alleles, cystic fibrosis transmembrane conductance regulator mutations, and polymorphisms of solute carrier 11A1 (or natural resistance-associated macrophage protein 1) and the vitamin D receptor.Information is also accruing about acquired systemic causes of susceptibility to NTMLD, including inhibitory antibodies directed against interferon-c, post-menopausal waning of endogenous oestrogen levels, coeliac disease and exposure to use of dietary phyto-oestrogens. It is not known whether immunosuppressive factors, such as oral corticosteroid treatment, chronic renal failure, diabetes mellitus and other known risk factors for pulmonary tuberculosis, are also risk factors for the development of NTMLD. Caution is appropriate in managing such patients.

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Section: Diabetes Mellitusmentioning

confidence: 99%

Susceptibility to nontuberculous mycobacterial lung disease: Table 1—

Sexton¹,

Harrison²

2008

Eur Respir J

143

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“…These NTM are ubiquitous organisms, living in soil, water, and dust. Infections with these organisms, in particular group IV (the rapidly growing mycobacteria, including Mycobacterium fortuitum and chelonae ) have been reported in patients on PD, causing exit site infections and peritonitis (61–69), and more rarely, in HD patients (70–75). These infections are often, but not always, due to contaminated water or dialysis fluid, or in cases of HD, by infected dialyzers (72,76).…”

Section: Infections By Nontuberculous Mycobacteriamentioning

confidence: 99%

Tuberculosis and Chronic Renal Disease

Hussein

Mooij

Roujouleh

2003

Seminars in Dialysis

181

164

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There is an increased risk (6.9- to 52.5-fold) of tuberculosis (TB) in patients with chronic renal failure and on dialysis as compared to the general population. The symptomatology in renal patients is often insidious and nonspecific, mimicking uremic symptoms, whereas the localization is often extrapulmonary (most frequently tuberculous lymphadenitis and peritonitis). Tuberculous peritonitis makes up a large part (37%) of the total number of TB cases in continuous ambulatory peritoneal dialysis (CAPD) patients. The prognosis is very much dependent on early diagnosis and treatment. Renal physicians should be aware of the unusual presentation and localization, and include TB in the differential diagnosis of any patient having nonspecific symptoms like anorexia, fever, and weight loss. All efforts should then be made (including invasive investigations) to reach an early diagnosis, a major determinant of the outcome. However, if this is not possible or the result is negative and the diagnosis remains strongly suspected, an empirical trial with anti-TB medication is justified, especially in endemic areas. In view of the increased prevalence of the disease in the dialysis population, TB prophylaxis is recommended in those patients with a positive tuberculin (Mantoux) skin test and radiographs suggestive of old TB.

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“…A PubMed search for data on M. xenopi published from 1975 to 2005 retrieved only 9 cases of arthritis [19,[26][27][28][29][30][31][32] and 2 cases of osteitis [33,34] (table 3). The infections reported in these studies followed a chronic indolent course without fever or evidence of systemic inflammation, which was in keeping with our findings.…”

Section: Discussionmentioning

confidence: 99%

“…We suggest the following criteria for differentiating contamination from infection of the bones and joints: recovery of M. xenopi in at least 1 synovial fluid or biopsy specimen, the existence of granulomas in synovial or bone biopsy specimens, clinical and radiological findings consistent 2, [26] 3, [27] 4, [28] 5, [29] 6, [30] 7, [34] 8, [31] 9, [15,16] 10, [32] 11, [19] Sex CIP, CLR (12) AZI, EMB with infection, and an absence of M. tuberculosis in bacteriological specimens. The treatment of osteoarticular M. xenopi infection is difficult.…”

Section: Discussionmentioning

confidence: 99%