Polymerase chain reaction confirmed Mycoplasma pneumoniae arthritis: a case report

We report here a case of polyarthritis caused by Mycoplasma pneumoniae in a 30 years old male who initially triggered suspicion of tuberculosis. Synovial fluid subjected to AFB smear, culture and PCR for Mycobacterium tuberculosis along with culture for aerobic and anaerobic bacteria by standard methods were negative. Synovial fluid was found to be positive by PCR for M. pneumoniae amplifying 543 bp fragment of P1 gene, however it could not be grown in culture. Specific IgG immunoglobulins to M. pneumoniae were also detected in synovial fluid as well as serum by ELISA which were further confirmed by IgG immunoblotting showing response to M. pneumoniae proteins specially immunodominant protein P1. The finding that both M. pneumoniae DNA and specific antibodies to M. pneumoniae are present in synovial fluid of the patient suggests that M. pneumoniae play an important role in arthritis. To the best of our knowledge, this is the first PCR confirmed M. pneumoniae infection in synovial fluid from a case of polyarthritis.