Mycobacterium abscessus Prosthetic Joint Infections of the Knee

Area of Science:

• Infectious Diseases
• Microbiology
• Orthopedic Surgery

Background:

• Prosthetic joint infections (PJI) of the knee are serious complications following joint replacement surgery.
• The Mycobacterium abscessus complex, particularly M. abscessus subspecies massiliense, is an emerging cause of opportunistic infections.
• Infections of the knee due to this specific nontuberculous mycobacterium (NTM) are exceptionally rare.

Observation:

• A patient developed a peri-prosthetic knee infection with Mycobacterium abscessus subsp. massiliense.
• Initial presentation included wound drainage, which progressed to sepsis.
• This clinical scenario underscores the potential severity of NTM infections in orthopedic implants.

Findings:

• The review of published literature on knee PJIs caused by M. abscessus complex reveals diverse clinical presentations.
• Common themes include insidious onset, challenging diagnosis, and the need for prolonged antimicrobial therapy.
• Surgical intervention is often a critical component of successful treatment alongside medical management.

Implications:

• This case and literature review emphasize the importance of considering NTM, particularly M. abscessus, in the differential diagnosis of recalcitrant or unusual prosthetic joint infections.
• Early recognition and appropriate antimicrobial and surgical strategies are crucial for optimizing patient outcomes.
• Further research into optimal treatment regimens for these rare infections is warranted.