Synovial hand infection from mycobacterium terrae

Deenstra, Wilco

doi:10.1016/0266-7681(88)90105-2

Cited by 16 publications

(6 citation statements)

References 6 publications

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“…2,6 Orthopedic infection caused by the M terrae complex (M terrae, Mycobacterium nonchromogenicum, and Mycobacterium triviale) and related species has been infrequently described. [7][8][9][10][11][12][13][14][15][16][17][18][19] Most cases of orthopedic infection caused by the M terrae complex involve the tenosynovium of the hand and wrist. 6,8,[10][11][12][13][14]16,17 To the authors' knowledge, only 3 cases of M terrae infection in large joints have been reported.…”

Section: Discussionmentioning

confidence: 99%

Large Joint Osteoarticular Infection Caused by Mycobacterium arupense

Seidl¹,

Lindeque²

2014

Orthopedics

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Nontuberculous mycobacteria tenosynovitis and osteoarticular infections have increased during the past 25 years. At least 15 different species of atypical mycobacteria have been mentioned in the literature as the cause of orthopedic infections. Mycobacterium arupense is a recently discovered species that is closely related to the Mycobacterium terrae complex. A review of the literature found M arupense cited as the cause of a single case of tenosynovitis of the hand. To the authors' knowledge, this organism has never been cited as the cause of a large joint infection. This article describes a case of knee osteoarticular infection caused by M arupense in a 69-year-old woman with no known immunocompromising comorbidities. The patient had more than a decade of knee pain and infection refractory to multiple surgical debridements and broad-spectrum antibiotics. Radical debridement with synovectomy and large-quantity bone resection cleared the infection with more than 2 years of follow-up. Clinically relevant findings in this case include the unusual and challenging nature of diagnosing and treating atypical mycobacterial musculoskeletal infection. The operative principles and techniques that apply to other bacterial osteoarticular infections are appropriate for musculoskeletal infection with M arupense. Furthermore, correct identification and speciation of atypical mycobacteria is crucial to guide antibiotic treatment.

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Section: Discussionmentioning

confidence: 99%

Large Joint Osteoarticular Infection Caused by Mycobacterium arupense

Seidl¹,

Lindeque²

2014

Orthopedics

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“…In 1967, the Centers for Disease Control in the United States reported 5 clinically significant cases of M terrae infection. Over 50 cases of M terrae infection have been reported, involving bone and other synovial structures, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] lungs, [19][20][21][22] skin, 19,23 gut, 24 urinary tract, lymph nodes or disseminated disease. 19,23,25 The most common site is the tenosynovium of the hand and wrist.…”

Section: Discussionmentioning

confidence: 99%

Infectious Arthritis of the Knee Caused by Mycobacterium Terrae: A Case Report

Milne¹,

Arnold²,

Hudson³

et al. 2009

J Orthop Surg (Hong Kong)

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Mycobacterium terrae is ubiquitous in our environment. M terrae infections most commonly involve tendon sheaths, bones, bursae, and joints. We report a case of infectious arthritis of the knee caused by M terrae in a 21-year-old man who had non-specific chronic synovitis. No organism was seen on microscopy or isolated from cultures until months later. Initially the M terrae culture was considered a contaminant and specific anti-mycobacterial treatment was not advised. The patient was commenced on suppressive therapy for persistent effusion and discomfort. Eventually, the M terrae infection was confirmed and he was commenced on clarithromycin, ciprofloxacin, and ethambutol. The triple antibiotic regimen was continued for 2 years. The knee improved but never completely settled. The patient chose to cease all antibiotic medication. The knee remained swollen and irritable, with little chance of eradicating the organism.

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“…10,12,14 However, M. terrae complex, as well as other mycobacterial pathogens, is frequently unidentified even with Ziehl-Neelsen preparation, and only indirect findings of mycobacterial infection (granulomatous inflammation with or without caseation, giant cells, lymphocytic infiltration, and focal fibrinoid necrosis) are found, which may serve as the initial suspicion of closed-space atypical mycobacterial infection. 10,12,14 However, M. terrae complex, as well as other mycobacterial pathogens, is frequently unidentified even with Ziehl-Neelsen preparation, and only indirect findings of mycobacterial infection (granulomatous inflammation with or without caseation, giant cells, lymphocytic infiltration, and focal fibrinoid necrosis) are found, which may serve as the initial suspicion of closed-space atypical mycobacterial infection.…”

Section: Histological and Microbiological Findingsmentioning

confidence: 99%

“…2,6 In addition, some cases of M. terrae joint infection have resolved with surgery alone 1,4,14,16 or with surgery and antituberculosis chemotherapy. Although antimycobacterial agents rifampin and isoniazid have been used to treat M. terrae complex infections, they have not been established as a standard of care or as empiric therapy because of the paucity of data and variable success.…”

Section: In Vitro Antibiotic Susceptibility and Treatment Of M Terramentioning

confidence: 99%

Successful Treatment of Mycobacterium terrae Complex Infection of the Knee

Lembo

Goldstein²,

Troum³

et al. 2012

JCR: Journal of Clinical Rheumatology

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Mycobacterium terrae is an unusual, ubiquitous organism that can cause clinical disease in both immunocompetent and immunocompromised hosts and can be difficult to diagnose and treat. We report a case of a 61-year-old man with a septic knee whose arthroscopy cultures grew M. terrae. The patient was successfully treated using a 6-month regimen of clarithromycin and sulfamethoxazole. Mycobacterium terrae should be considered in the differential diagnoses for monoarticular swelling and pain of unknown etiology, especially in the setting of initially negative routine microbiological cultures.

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Synovial hand infection from mycobacterium terrae

Abstract: A case of extensive synovial infection in the hand due to Mycobacterium terrae is described. The infection is resistant to drug therapy but appears to remain localised.

Cited by 16 publications

References 6 publications

Large Joint Osteoarticular Infection Caused by Mycobacterium arupense

Large Joint Osteoarticular Infection Caused by Mycobacterium arupense

Infectious Arthritis of the Knee Caused by Mycobacterium Terrae: A Case Report

Successful Treatment of Mycobacterium terrae Complex Infection of the Knee

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