Delayed recognition of a pseudo-outbreak of Mycobacterium terrae

Successful Treatment of Mycobacterium terrae Complex Infection of the Knee

“…5Y7,12,15,17,19 Milne and colleagues 5 described their case of a 21-year-old man with left knee infectious arthritis caused by M. terrae treated with multiple arthroscopies, synovectomies, and an antimycobacterial regimen of clarithromycin, ciprofloxacin, linezolid, and ethambutol over the course of 8 years, with the patient ultimately ceasing all antibiotic medication and no clinical improvement achieved. 6,20 The patient in our case report had been treated with synovectomy and multiple arthroscopies; however, improvement did not occur through surgical means alone. Smith and colleagues 6 also described statistics regarding 29 upper-extremity cases of the 52 total cases in their literature review.…”

“…2,6,11,18,19 Treatment for other osteoarticular or autoimmune conditions without an accurate or with an equivocal diagnosis may worsen the patient's condition, due to the anti-inflammatory properties of intra-articular or systemic corticosteroid use 1,6,10,12,14,15,17 ; introduction may occur through an improperly sterilized needle into joint spaces or through contaminated fluids used for arthroscopy or unsterilized arthroscopic devices. 5,20 Mycobacterium terrae should remain a diagnostic consideration in cases of chronic and insidious monoarticular swelling of unknown etiology with no obvious cause of autoimmunity or joint disease on routine clinical, radiographic, or laboratory findings. 5,20 Mycobacterium terrae should remain a diagnostic consideration in cases of chronic and insidious monoarticular swelling of unknown etiology with no obvious cause of autoimmunity or joint disease on routine clinical, radiographic, or laboratory findings.…”

Infectious Arthritis of the Knee Caused by Mycobacterium Terrae: A Case Report

“…It was unknown whether the initial M terrae culture was a contaminent or a pathogen. An outbreak of 163 false positive M terrae infections secondary to contaminated hospital water supply 29 and a pseudooutbreak of M terrae secondary to contamination of specimens in the laboratory 30 have been reported. A single isolation of M terrae is easily dismissed as a contaminant or non-pathogenic coloniser, because it is ubiquitous in temperate climates.…”

Point-of-Use Membrane Filtration and Hyperchlorination to Prevent Patient Exposure to Rapidly Growing Mycobacteria in the Potable Water Supply of a Skilled Nursing Facility

“…7 Environmental xenopi, have previously been associated with pseudo-outbreaks among hospitalized patients. [8][9][10][11][12][13][14][15][16][17][18][19] Frequently, systemwide contamination of hospital tap water with mycobacteria is the source for pseudo-outbreaks. The current investigation included an assessment of potential exposures for SNF A patients and an evaluation of interventions to reduce exposures to nontuberculous mycobacteria.…”