<i>Mycobacterium Chelonae</i> Infection after Total Knee Arthroplasty: A Case Report

Lee, Raymond Peter; Cheung, Kwok W.; Chiu, Kwong Yuen; Tsang, Man Leung

doi:10.1177/230949901202000130

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…reported no relapse in 10 months after more than 9 months of ATT. However, there are few reports demonstrating complete cure only after 3 months of therapy 3. On the contrary, we treated our patient with total of 5 months of therapy and stopped it after 6 weeks of normal inflammatory markers and negative tissue culture isolate.…”

Section: Discussionmentioning

confidence: 68%

“…Literature describes total of 25 cases of PJI, including 16 cases of knee-PJI, by RGM species including Mycobacterium chelonae , Mycobacterium smegmatis , Mycobacterium fortuitum , Mycobacterium wolinskyi , and M. abscessus ,123456789 of which only four were associated with M. abscessus 1489 [Table 1]. Diagnosis is frequently delayed due to similar clinical and laboratory presentation to a bacterial abscess and lack of its growth in routine culture adding to morbidity 7.…”

Section: Discussionmentioning

confidence: 99%

“…Many authors recommend removal of implants,3891718 especially in case of M. abscessus which is considered as one of the most resistant organisms to chemotherapeutic agents 118. Nevertheless, there is no common consensus on removal of well fixed prosthesis as there are few reports documenting complete eradication of infection with ATT only with retention of well fixed implants 12.…”

Section: Discussionmentioning

confidence: 99%

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Prosthetic knee joint infection due to Mycobacterium abscessus

Amit¹,

Rastogi

Marya

2017

IJOO

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Infected total knee arthroplasty (TKA) due to Mycobacterium abscessus is very rare with only three such cases described in literature. Only one case was managed successfully, however, with a prolonged course of anti tubercular therapy. In this case report, we present an elderly lady with infected TKA after 2 years of the primary procedure. Although initially it grew different bacteriae, M. abscessus was isolated during the second debridement. She was successfully treated with total of 5 months of second line anti tubercular drugs with revision prosthesis performed during chemotherapy. Two years followup revealed satisfactory outcome with no relapse.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prosthetic knee joint infection due to Mycobacterium abscessus

Amit¹,

Rastogi

Marya

2017

IJOO

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“…A case study demonstrated that NTM infection could be successfully treated with a single‐stage revision 26 . Nevertheless, the majority of studies indicated that two‐stage revision is the surgeon's preferred treatment for NTM PJI 35–45 …”

Section: Discussionmentioning

confidence: 99%

“…We reviewed 39 articles, including 68 patients with PJI caused by NTM [18,21‐58]. Subsequently, all 68 patients were analyzed in detail.…”

Section: Literature Reviewmentioning

confidence: 99%

Non‐Tuberculosis Mycobacterium Periprosthetic Joint Infections Following Total Hip and Knee Arthroplasty: Case Series and Review of the Literature

Maimaiti,

Li,

et al. 2023

Orthopaedic Surgery

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Objective: Periprosthetic joint infection (PJI) caused by non-tubercular mycobacteria (NTM) is uncommon but catastrophic. However, conclusive clinical data on PJI caused by NTM are lacking. In this case series and systematic review, the clinical manifestations, diagnosis, and management of NTM PJI are summarized and analyzed. Methods:From 2012 to 2020, we retrospectively analyzed consecutive PJI cases caused by NTM in our institution.A literature review was also conducted from January 2000 to December 2021, utilizing the PubMed, MEDLINE, Cochrane Library, and EMBASE databases to identify all reported NTM-induced PJI cases. The clinical characteristics, demographics, pathogen identification, treatment protocols, and prognosis of NTM PJI were summarized and analyzed. Results:In this retrospective analysis, seven patients infected with NTM following total joint arthroplasty at our institution were included, including six cases of PJI caused by NTM and one case of septic arthritis (SA) caused by NTM. There were six men and one woman, and their average age was 62.3 years. The average interval between TJA and PJI onset was 4 months. The preoperative serological markers, including the mean ESR (51 mm/h), CRP (4.0 mg/dL), fibrinogen (5.7 g/L), and D-dimer (1.1 g/L), were increased. Six patients underwent staged revision surgery, and one patient with SA received antibiotic-loaded bone cement beads to treat the infection. After an average of 33 months of observation following surgical intervention, none of the patients showed any symptoms of infection recurrence. From 2000 to 2021, 68 patients with NTM PJI were found in 39 studies in the published literature. Reinfections occurred within 1 year after arthroplasty in more than half (53.2%) of the patients. M. fortuitum and M. abscesses were the most prevalent rapidly growing mycobacteria (RGM) in all PJI patients, whereas Mycobacterium avium intracellulare (MAC) was the most prevalent slowly growing mycobacterium (SGM). The corresponding antibiotics were amikacin and ethambutol. The rate of culture-negative without specific clinical symptoms was as high as 36.4% (12/33), while 45% (18/40) utilized additional diagnostic techniques such as NGS. A final clinical follow-up record was available for 59 patients (86.7%; mean follow-up period, 29 months), and 10.1% of patients failed to respond to treatment. Conclusion:Orthopaedic surgeons should consider NTM in patients with negative routine cultures who are at risk for Mycobacterium infection. Treatment options rely on the accurate result of microbiologic identification and drug sensitivity testing, and to achieve this, it may be necessary to send multiple culture specimens, extend the culture time, and change the culture medium. Every effort should be made to identify NTM and its various subtypes through modern diagnostic tools if necessary.

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Acute Osseous Injury to the Ankle and Foot

Elīna,

Monta

2023

Musculoskeletal Imaging

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Mycobacterium Chelonae Infection after Total Knee Arthroplasty: A Case Report

Cited by 8 publications

References 10 publications

Prosthetic knee joint infection due to Mycobacterium abscessus

Prosthetic knee joint infection due to Mycobacterium abscessus

Non‐Tuberculosis Mycobacterium Periprosthetic Joint Infections Following Total Hip and Knee Arthroplasty: Case Series and Review of the Literature

Acute Osseous Injury to the Ankle and Foot

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