J Rheum Dis.  2011 Jun;18(2):122-124.

A Case of Arthritis due to Mycobacterium Intracellulare in a Immunocompetent Patient

• Kang GH
• Kim SH
• Lee HY
• Seo HW
• Song EH
• Lee KW
• Kim SS

Abstract

Nontuberculous mycobacteria (NTM) are widely distributed in nature and are usually of low pathogenic potential. NTM rarely has been recognized as a cause of musculoskeletal infections that involve joints, bone and soft tissue in immunocompetent patients. The risk factors of its infection are local traumas caused by surgery, injury, or injection. A fifty five-year-old immunocompetent patient visted to hospital due to right wrist mass and pain. Excisional biopsy was done. Histologically granulomatous inflammation was identified and Mycobacterium intracellulare was cultured. Although very rare, NTM should be suspected at least once as a causative pathogen of chronic arthritis when the cause is uncertain.

Keyword

Mycobacterium intracellulare; Arthritis; Immunocompetent patient

MeSH Terms

Arthritis
Biopsy
Humans
Inflammation
Joints
Mycobacterium
Mycobacterium avium Complex
Nontuberculous Mycobacteria
Risk Factors
Wrist

Figure

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  Figure 1. Histologic examination of synovial tissue. Chronic inflammation with histiocytic and epithelioid aggregation (granu-loma) (arrow) is shown (H&E, ×200).

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  Figure 2. Radiograph in oblique projection of right wrist reveals multiple bone erosions in the distal radius, ular (arrows) and carpal bone (arrowheads).

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  Figure 3. (A) Axial gadolinium- enhanced T1-weighted MR image shows synovial proliferation (arr-ows), bone erosion and bone marrow edema (arrowheads), (B) Sagittal T2-weighted MR image shows radius bone erosion (arrow) and soft tissue mass (arrowhead).

Reference

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