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Mycobacterium marinum arthritis

J A Alloway1, S M Evangelisti, J S Sartin

  • 1Department of Internal Medicine, Malcolm Grow Medical Center, Andrews Air Force Base, MD 20331, USA.

Seminars in Arthritis and Rheumatism
|June 1, 1995
PubMed
Summary

Mycobacterium marinum rarely causes septic arthritis, typically affecting the hands or wrists after trauma or marine exposure. Early diagnosis via Ziehl-Nielson stain and Lowenstein-Jenson culture, followed by 6-month antimycobacterial therapy, is crucial.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Rheumatology

Background:

  • Mycobacterium marinum is an atypical acid-fast bacterium.
  • Septic arthritis caused by M. marinum is uncommon, usually presenting as monarticular synovitis.
  • Risk factors include periarticular trauma and exposure to marine environments.

Observation:

  • Clinical presentation often involves the hands or wrists.
  • Diagnosis relies on identifying the organism in tissue samples.
  • Ziehl-Nielson stain and Lowenstein-Jenson medium are key diagnostic tools.

Findings:

  • Optimal growth of M. marinum occurs in Lowenstein-Jenson medium.
  • Effective therapy requires at least two antimycobacterial agents for a minimum of 6 months.

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  • Surgical debridement may be a beneficial adjunct treatment.

    • Implications:

    • Clinicians need a high index of suspicion for M. marinum infection.
    • Prompt initiation of appropriate stains, cultures, and antimycobacterial therapy is essential.
    • Early and accurate diagnosis improves patient outcomes for this rare form of septic arthritis.