Imaging Characteristics and Epidemiologic Features of Atypical Mycobacterial Infections Involving the Musculoskeletal System

Theodorou, Daphne J.; Theodorou, Stavroula J.; Kakitsubata, Yousuke; Sartoris, David J.; Resnick, Donald

doi:10.2214/ajr.176.2.1760341

Cited by 54 publications

(27 citation statements)

References 57 publications

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“…In India, the frequency of isolation of NTMs in different studies ranges from 0.7 to 34% (Chakraborti et al, 1990). The most commonly reported manifestations of atypical mycobacterial infections involving the musculoskeletal system are osteomyelitis, septic arthritis, cellulitis, abscess, septic myositis, septic bursitis, septic tenosynovitis and carpal tunnel syndrome (Theodorou et al, 2001). Localized pain, swelling and draining sinus tracts persisting for 4-8 weeks following accidental trauma is most commonly associated with osteomyelitis caused by NTMs (Theodorou et al, 2001;Devi et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

“…These bacteria can cause various infections such as skin and soft tissue infections, pneumonia, endocarditis and disseminated disease in immunocompromised patients (Eid et al, 2007). Involvement of the musculoskeletal system occurs in approximately 5-10% of patients with atypical mycobacterial infections (Theodorou et al, 2001). Infection is usually acquired through contamination from surgical procedures or penetrating injuries and hematogenous spread (Wolinsky, 1992;Resnick and Niwayama, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…Mycobacterium fortuitum has been known to cause a variety of manifestations ranging from skin and soft tissue infection to disseminated infections (Unni et al, 2005). The onset of infection is usually nonspecific, gradual and usually includes local pain and swelling, joint stiffness, low grade fever, sweats, chills, anorexia, malaise and weight loss (Theodorou et al, 2001). These non-specific clinical manifestations of disease along with a lack of familiarity with these pathogens can result in a delay in diagnosis.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Osteomyelitis Caused by <i>Mycobacterium fortuitum</i>-a Case Report

Lyngdoh¹,

Khyriem²,

Lyngdoh³

et al. 2016

American Journal of Infectious Diseases

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Non-tuberculous rapidly growing mycobacteria have been known to cause a variety of skin and soft tissue infection. The diagnosis of NTM in bone and joint infections is easily missed because of nonspecific signs and symptoms. We report a case of a 65 year old male with osteomyelitis of the right knee of 4 years duration. The patient had no prior history of trauma or injury and finally presented with discharging sinus and edema of the right knee. The discharge persisted in spite of empiric therapy with anti-tubercular therapy. Rapidly growing Mycobacteria was isolated from the exudate which was identified as Mycobacterium fortuitum based on biochemical analysis. The isolate was found to be susceptible to Clarithromycin, Clindamycin, Gentamicin, Amikacin, Tetracycline, Co-trimoxazole and Imipenem The patient responded to medical therapy by oral Clarithromycin. An accurate diagnosis and effective treatment of an atypical mycobacteria infection of the musculoskeletal system is therefore mandatory to prevent severe bone and joint destruction. With non-specificity of imaging findings and clinical symptoms and signs, culture of mycobacteria becomes crucial in establishing the diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Osteomyelitis Caused by <i>Mycobacterium fortuitum</i>-a Case Report

Lyngdoh¹,

Khyriem²,

Lyngdoh³

et al. 2016

American Journal of Infectious Diseases

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“…The synovial inflammation was consistent with the preoperative imaging findings of enhancement and edematous changes. postsurgical wound infections, as well as softtissue infections acquired at dialysis centers, nail salons, and swimming pools (2,3).…”

Section: Discussionmentioning

confidence: 99%

Nontuberculous Mycobacterial Tenosynovitis:AIRP Best Cases in Radiologic-Pathologic Correlation

Wells

Strickland²,

Schowinsky³

et al. 2015

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“…It is difficult to differentiate between the 2 entities using imaging alone because of their similar radiological features. 12 MAC is usually resistant to most anti-tuberculosis drugs. 4,6,9 In one case it was resistant to isoniazid, streptomycin, ethionamide, and pyrazinamide.…”

Section: Gib Denotes Gastrointestinal Bleedingmentioning

confidence: 99%

Spinal Infection Caused by Mycobacterium Avium Complex in a Patient with No Acquired Immune Deficiency Syndrome: A Case Report

Wong

Sun

Lau

2008

J Orthop Surg (Hong Kong)

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Spinal infection caused by Mycobacterium avium complex (MAC) is rarely seen in people who do not have acquired immune deficiency syndrome. We report such a case in a 60-year-old man who underwent anterior spinal fusion after treatment with antibiotics had failed. The presentation of MAC spinal infection is different from that seen in MAC lung infection, with more than half presenting with urgent or semi-urgent neurological deficits. Younger patients who are not immunocompromised can also be infected. It should be considered as a differential diagnosis in patients with tuberculosis of the spine. The use of antibiotics should be based on the cultured organism's sensitivity results. Indications for surgery are progressive bony destruction, abscess formation, and neurological compression. CASE REPORTIn March 2004, a 60-year-old man presented to our hospital with a 6-month history of back pain, unrelated to any trauma. Two years earlier, one of his fingers became infected and the culture grew Proteus, Staphylococcus aureus, and Serratia. The finger was partially amputated and the wound healed eventually.He was hypertensive and had gout but was not diabetic, immunocompromised or using steroids. A physical examination found diffuse tenderness over the mid-lumbar region but no other signs suggestive of neurological involvement. He was afebrile and had a negative psoas sign. Radiographs revealed erosion of the lower endplate of L2 and upper endplate of L3 vertebral bodies (Fig. 1). The psoas shadows were not noticeably increased on both sides. Blood tests showed a raised erythrocyte sedimentation rate of 44 mm/hr and a C-reactive protein level of 16 mg/l with a normal white cell count. The white cell differential counts were within normal ranges (neutrophil count, 5.2 x10 9 /l; lymphocyte count, 1.6 x10 9 /l). The fasting blood sugar was 5.4 mmol/l. The renal and liver

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Imaging Characteristics and Epidemiologic Features of Atypical Mycobacterial Infections Involving the Musculoskeletal System

Cited by 54 publications

References 57 publications

Osteomyelitis Caused by <i>Mycobacterium fortuitum</i>-a Case Report

Osteomyelitis Caused by <i>Mycobacterium fortuitum</i>-a Case Report

Nontuberculous Mycobacterial Tenosynovitis:AIRP Best Cases in Radiologic-Pathologic Correlation

Spinal Infection Caused by Mycobacterium Avium Complex in a Patient with No Acquired Immune Deficiency Syndrome: A Case Report

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