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Mycobacterium malmoense septic arthritis.

S E Whitehead1, K D Allen, V E Abernethy

  • 1Department of Microbiology, Whiston Hospital, Prescot, Merseyside L35 5DR, UK.

The Journal of Infection
|December 31, 2002
PubMed
Summary

A rare case of septic arthritis and osteomyelitis caused by Mycobacterium malmoense occurred in a man with rheumatoid arthritis. The infection was successfully treated with a combination of ethambutol, rifampicin, and clarithromycin.

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Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Microbiology

Background:

  • Rheumatoid arthritis (RA) patients on immunosuppressive therapy are susceptible to opportunistic infections.
  • Mycobacterium malmoense typically causes pulmonary disease or cervical lymphadenitis, rarely affecting joints.

Observation:

  • A 61-year-old male with a 20-year history of rheumatoid arthritis, treated with steroids and azathioprine, presented with septic arthritis of an interphalangeal joint and osteomyelitis of the phalanx.
  • Diagnosis was confirmed as infection due to Mycobacterium malmoense.

Findings:

  • This represents the first reported case of septic arthritis and osteomyelitis of a digit caused by Mycobacterium malmoense.
  • Successful treatment was achieved using a combination regimen of ethambutol, rifampicin, and clarithromycin.

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Implications:

  • Highlights the potential for Mycobacterium malmoense to cause severe bone and joint infections in immunocompromised individuals.
  • Suggests that a broader spectrum of clinical presentations should be considered for Mycobacterium malmoense infections.
  • Demonstrates the efficacy of ethambutol, rifampicin, and clarithromycin in treating this rare presentation of Mycobacterium malmoense infection.