Mycobacterium avium-intracellulare infection of the knee joint. Case report

A 57-year-old white male with a history of scleroderma developed an osteoarticular infection of the right knee caused by Mycobacterium avium-intracellulare. The patient underwent arthroscopic synovectomy and was started on appropriate combination chemotherapy. The patient failed to improve clinically and developed osteomyelitis of the patella, distal femur, and proximal tibia. The patient refused further surgical intervention and subsequently developed a "Charcot-like" knee joint. This case report documents the failure of medical treatment alone for this infection, which must be combined with aggressive surgical intervention.