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Mycobacterium kansasii osteomyelitis - a masquerading disease.

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Non-tuberculous mycobacteria (NTM) can cause infections beyond the lungs. This case highlights the diagnostic challenges of Mycobacterium kansasii joint infections, even without typical granulomas.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Rheumatology

Background:

  • Non-tuberculous mycobacteria (NTM) are environmental pathogens causing opportunistic infections.
  • Mycobacterium kansasii typically causes pulmonary disease, especially in immunocompromised individuals.
  • Extrapulmonary M. kansasii infections are rare, but can affect joints, skin, and soft tissues.

Observation:

  • An unusual case of sternoclavicular and elbow joint infection by M. kansasii is presented.
  • The patient was relatively immunocompetent, complicating initial suspicion.
  • Initial histopathology failed to reveal characteristic granulomas, delaying diagnosis.

Findings:

  • Repeat biopsies and mycobacterial cultures were crucial for identifying M. kansasii.
  • M. kansasii can cause infection without forming classic granulomas.
  • Culture results require careful interpretation due to potential environmental contamination.

Implications:

  • Diagnosing M. kansasii extrapulmonary infections can be challenging.
  • Characteristic granuloma formation is not always present in M. kansasii infections.
  • Routinely culturing tissue samples for mycobacteria is essential for accurate diagnosis.