Successful management of Mycoplasma hominis septic arthritis involving a cementless prosthesis

Nylander, Nicola; Tan, Mark Chin Hung; Newcombe, David S.

doi:10.1016/s0002-9343(89)80164-0

Cited by 22 publications

(7 citation statements)

References 27 publications

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“…The rate of septic arthritis due to Mycoplasma hominis was the highest, and Ureaplasma urealyticum, Mycoplasma pneumoniae, and Mycoplasma salivarium were also identified. These results were consistent with a previous study [36]. Previous literature indicated that patients with malignancies, hypogammaglobulinemia, a history of organ transplant, AIDS or other immunodeficiency disease, or a history of immunosuppressant use, such as glucocorticoids, vinca alkaloids, and cyclosporine, were defined as immunocompromised [45].…”

Section: Discussionsupporting

confidence: 92%

Diagnosis and treatment of mycoplasmal septic arthritis: a systematic review

Chen

Huang

Fang

et al. 2019

International Orthopaedics (SICOT)

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Purpose Septic arthritis caused by Mycoplasma is rare. The diagnosis and effective treatment of mycoplasmal septic arthritis remains a serious problem for clinicians. The aim of this systematic review was to document the available evidence on the diagnosis and treatment methods for mycoplasmal septic arthritis and to provide guidance for clinicians. Methods The PubMed, EMBASE, and Cochrane Library databases were searched in December 2018.The searches were limited to the English language. Article screening and data extraction and compilation were conducted by two independent reviewers. All the included studies were assessed using the Methodological Index for Non-randomized Studies (MINORS) tool. Results There was a total of 33 articles including 34 cases of mycoplasmal septic arthritis and eight of them were periprosthetic joint infection (PJI). Twenty-four patients (70.6%) were immunocompromised, and the synovial fluid white blood cell (WBC) count was significantly lower in the immunocompromised group than in the immunocompetent group (48,527 × 10 6 /L vs. 100,640 × 10 6 /L; P = 0.009). The traditional culture method took longer, and the positivity rate was lower than that of nucleic acid testing (50% vs. 100%; P = 0.016). Only 19.2% (5/26) of patients treated with empiric antibiotics were relieved of symptoms, while 82.4% (28/34) of patients achieved satisfactory results after being treated with antibiotics against Mycoplasma. Conclusion The possibility of mycoplasmal septic arthritis should be considered if patients with joint infections have a history of immunocompromised, repeated negative cultures, and poor empiric antibiotic treatment results. The rational use of nucleic acid testing technologies can help in the clinical diagnosis and treatment of mycoplasmal septic arthritis.

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Section: Discussionsupporting

confidence: 92%

Diagnosis and treatment of mycoplasmal septic arthritis: a systematic review

Chen

Huang

Fang

et al. 2019

International Orthopaedics (SICOT)

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“…Septic arthritis due to M. hominis has been reported previously, and most patients were receiving immunosuppressive therapy for SLE, post-organ transplantation, leukemia, or underlying immunosuppressive disease such as hypogammaglobulinemia or diabetes mellitus (14)(15)(16)(17)(18)(19)(20). Arthroplasty and ligament repair were also underlying conditions (14,15).…”

Section: Discussionmentioning

confidence: 92%

“…Arthroplasty and ligament repair were also underlying conditions (14,15). Previous reports of septic arthritis due to M. hominis showed that monoarthritis or oligoarthritis of large joints such as the knee, shoulder and/or hip first occur (14)(15)(16)(17)(18)(19)(20) and then polyarthritis develops in the small joints (16,18). In the case presented here, two months had passed before admission to hospital and polyarthritis in six large (bilateral hips, knees, shoulders) and one small (the PIP joint of the right middle finger) joints had developed.…”

Section: Discussionmentioning

confidence: 99%

Hypogammaglobulinemic Patient with Polyarthritis Mimicking Rheumatoid Arthritis Finally Diagnosed as Septic Arthritis Caused by Mycoplasma hominis

et al. 2012

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Hypogammaglobulinemia is a reduction or absence of immunoglobulin, which may be congenital or associated with immunosuppressive therapy. In addition to infectious diseases, autoimmune diseases have also been reported in patients with hypogammaglobulinemia. A 26-year-old man with hypogammaglobulinemia had multiple joint pain and swelling with erosive changes in the proximal interphalangeal joint of the right middle finger on X-ray film, mimicking rheumatoid arthritis (RA). As polyarthritis remained after immunoglobulin replacement therapy and there was no finding indicating any infection at that time, a diagnosis of RA was made. Prednisolone and etanercept were started. However, his polyarthritis did not improve and he developed meningitis and massive brain ischemia. Finally, a diagnosis of disseminated Mycoplasma hominis infection was made. The differential diagnosis of polyarthritis in patients with hypogammaglobulinemia should strictly exclude Mycoplasma infection by culture with special media or longer anaerobic culture, and molecular methods for mycoplasma.

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“…All cases from the last decade were associated with postoperative wound infection after joint replacement surgery (Lee et al, 2009;Smith et al, 2016;Qiu et al, 2017). On the other hand, two articles from the mid-1980s reported two cases of PJI with M. hominis as the sole causative agent (Sneller et al, 1986;Nylander et al, 1989). Finally, a review article introduced 11 cases investigated by the authors with M. hominis infection occurring outside the genitourinary tract in adults, and 14 cases from the literature.…”

Section: Discussionmentioning

confidence: 99%

Periprosthetic joint infection associated with Mycoplasma hominis after transurethral instrumentation in an immunocompetent patient. Unusual or underestimated? A case report and review of the literature

Rieber¹,

Frontzek²,

Fischer

2019

International Journal of Infectious Diseases

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A B S T R A C TJudging by the small number of published cases, periprosthetic joint infections (PJI) caused by Mycoplasma species are regarded as unusual. This is not surprising as special growth conditions are necessary for diagnosis and therefore the laboratory must be informed of any clinical suspicion. However, surgeons are generally not aware of the risk factors associated with certain microorganisms causing an infection. Our laboratory therefore decided to adopt a new strategy: first, to address specific questions concerning the medical history of the patient and second, to make diagnosis of rare and fastidious microorganisms part of routine investigation, even if detailed information is not available.

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Successful management of Mycoplasma hominis septic arthritis involving a cementless prosthesis

Cited by 22 publications

References 27 publications

Diagnosis and treatment of mycoplasmal septic arthritis: a systematic review

Diagnosis and treatment of mycoplasmal septic arthritis: a systematic review

Hypogammaglobulinemic Patient with Polyarthritis Mimicking Rheumatoid Arthritis Finally Diagnosed as Septic Arthritis Caused by Mycoplasma hominis

Periprosthetic joint infection associated with Mycoplasma hominis after transurethral instrumentation in an immunocompetent patient. Unusual or underestimated? A case report and review of the literature

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