Successful Treatment of Mycobacterium terrae Complex Infection of the Knee

Lembo, G; Goldstein, Ellie J. C.; Troum, Orin; Mandelbaum, Bert R.

doi:10.1097/rhu.0b013e31826d1e11

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…The incidence of extrapulmonary NTM may be higher than our current estimation. NTM have potential to involve any human body organ and are commonly isolated from skin and soft tissue, lymphadenitis, septic arthritis, bone, and as disseminated infection [19–21]. A high index of clinical suspicion of disease and isolation of NTM from sterile site or any NTM growth from biopsy or compatible histopathology with mycobacterial disease are main keys to diagnose extrapulmonary NTM.…”

Section: Extrapulmonary Ntmmentioning

confidence: 99%

Highlight on Advances in Nontuberculous Mycobacterial Disease in North America

Mirsaeidi

Farshidpour

Allen

et al. 2014

BioMed Research International

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Nontuberculous mycobacteria (NTM) are ubiquitous in the environment and exist as an important cause of pulmonary infections in humans. Pulmonary involvement is the most common disease manifestation of NTM and the incidence of NTM is growing in North America. Susceptibility to NTM infection is incompletely understood; therefore preventative tools are not well defined. Treatment of pulmonary nontuberculous mycobacterial (NTM) infection is difficult and entails multiple antibiotics and an extended treatment course. Also, there is a considerable variation in treatment management that should be considered before initiating treatment. We highlight the new findings in the epidemiology diagnosis and treatment of mycobacterial infections. We debate new advances regarding NTM infection in cystic fibrosis patients and solid organ transplant recipients. Finally, we introduce a new epidemiologic model for NTM disease based on virulence-exposure-host factors.

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Section: Extrapulmonary Ntmmentioning

confidence: 99%

Highlight on Advances in Nontuberculous Mycobacterial Disease in North America

Mirsaeidi

Farshidpour

Allen

et al. 2014

BioMed Research International

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confidence: 99%

“…Antimicrobial susceptibility was determined at the Korean Institute of Tuberculosis using the CLSI agar microdilution method [5]. The isolate was susceptible to clarithromycin (minimal inhibi- TMP/SMX, and some aminoglycosides [1,6]. The M. virginiense isolate described in 2016 was susceptible to clarithromycin, ethambutol, rifabutin, and TMP/SMX, but was resistant to amikacin, rifampin, quinolone, doxycycline, and linezolid [2].…”

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confidence: 99%

First Report of Tenosynovitis Caused by Mycobacterium virginiense in Korea

Lee

Heo

et al. 2020

Ann Lab Med

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Dear Editor, Mycobacterium terrae complex (MTC) are slow-growing nontuberculous mycobacteria (NTM) that cause tenosynovitis, septic arthritis, and osteomyelitis of the extremities [1]. Eleven new species of MTC have been described since 2006 [2]. Mycobacterium virginiense, a member of the MTC, was first described in 2016, and isolates from patients with tenosynovitis and osteomyelitis are acid-fast, slow-growing, and nonpigmented on Middle brook 7H10 agar [2]. The first case of M. virginiense isolated from a human pulmonary specimen was reported in 2019 [3]. We report the first case of tenosynovitis caused by M. virginiense in Korea. This retrospective study was approved by the Institutional Review Board of Jeju National University Hospital, Jeju, Korea (No. 2019-07-018) that waived informed consent.A previously healthy 68-year-old woman was admitted to Jeju National University Hospital with painful swelling of the third finger of her left hand, which had been present for one month; her hand was treated with acupuncture two months before admission. She had a leukocyte count of 5.70 (reference range: 4.5-11.0) × 10 9 /L, an erythrocyte sedimentation rate of 41 (reference range: 0-20) mm/hr, and C reactive protein levels of 2.10 (reference range: 0.76-28.5) nmol/L. Magnetic resonance imaging of her left hand revealed an effusion, synovial proliferation of the flexor tendon sheath, and subcutaneous fat edema of the third finger ( Fig. 1). She was treated empirically with cefazolin and clindamycin for three weeks following which she underwent surgical debridement. Tenosynovitis and severe inflammatory changes of the soft tissue surrounding the flexor tendon were observed during surgery. Bacterial culture, acid-fast bacilli (AFB) stain, and tuberculosis (TB)-PCR were negative in the tissue specimen of the inflammatory soft tissue surrounding the tendon. On day 22, an AFB culture performed at the Korean Institute of Tuberculosis revealed an unidentified NTM. Cefazolin and clindamycin were discontinued, and oral clarithromycin (500 mg twice a day) and intravenous amikacin (10 mg/kg/day) and cefoxitin (12 g/day) were started, based on a presumptive diagnosis of rapid-growing NTM infection. Two weeks later, the regimen was changed to oral clarithromycin and ciprofloxacin (500 mg twice a day). The patient improved clinically and was discharged on hospital day 40.Molecular methods, including rpoB gene PCR, were used for definitive species identification, and slow-growing M. virginiense was confirmed with an accuracy of 99% (341/343 bp) using the basic local alignment search tool algorithm (Fig. 2) [4]. The rpoB

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Mycobacterium arupense, Mycobacterium heraklionense, and a Newly Proposed Species, “Mycobacterium virginiense” sp. nov., but Not Mycobacterium nonchromogenicum, as Species of the Mycobacterium terrae Complex Causing Tenosynovitis and Osteomyelitis

Vasireddy

Brown‐Elliott

et al. 2016

J Clin Microbiol

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Mycobacterium terrae complex (MTC) was first characterized in 1981 by the International Working Group in Mycobacterial Taxonomy (IWGMT). The initial MTC consisted of two nonchromogenic slowly growing species: M. terrae and Mycobacterium nonchromogenicum (1, 2). Phenotypic separation within the group was often difficult, and molecular methods were not available, making establishment of species pathogenicity uncertain (3).The complex is recognized as an environmental contaminant of sputum and a cause of tenosynovitis and osteomyelitis primarily of the fingers and wrist (3-35). Whether one or more members of the complex are true respiratory pathogens has not been established (1, 22).The first published case report of tenosynovitis caused by the MTC was by Hirata and Tomiyama in 1976 (4). There have been approximately 34 additional case reports published since then, identified using nonmolecular methods (3-25), with 14 cases identified using molecular methods (26)(27)(28)(30)(31)(32)(33)(34)(35)(36) (Tables 1 and 2). With the exception of four isolates of M. arupense, including the original description of M. arupense (28), details of the methods and/or explicitly stating a 100% 16S rRNA gene sequence identity to recognized species for the remaining cases with molecular identifications have been absent (Table 2).An excellent history and species update of the M. terrae complex based on multigene sequencing targets was published by Tortoli et al. (1). He noted that the presence of a two nucleotide insertion in helix 18 of the 16S rRNA gene (bp ϳ430 to 500; hypervariable region B or region V3) provided a consistent signature sequence for members of the MTC compared to other slowly growing mycobacteria (37,38). He also characterized several new species in the complex, including Mycobacterium heraklionense and Mycobacterium engbaekii (1).The greater availability of DNA sequencing (59) Citation Vasireddy R, Vasireddy S, Brown-Elliott BA, Wengenack NL, Eke UA, Benwill JL, Turenne C, Wallace RJ, Jr. 2016. Mycobacterium arupense, Mycobacterium heraklionense, and a newly proposed species, "Mycobacterium virginiense" sp. nov., but not Mycobacterium nonchromogenicum, as species of the Mycobacterium terrae complex causing tenosynovitis and osteomyelitis.

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Successful Treatment of Mycobacterium terrae Complex Infection of the Knee

Cited by 3 publications

References 19 publications

Highlight on Advances in Nontuberculous Mycobacterial Disease in North America

Highlight on Advances in Nontuberculous Mycobacterial Disease in North America

First Report of Tenosynovitis Caused by Mycobacterium virginiense in Korea

Mycobacterium arupense, Mycobacterium heraklionense, and a Newly Proposed Species, “Mycobacterium virginiense” sp. nov., but Not Mycobacterium nonchromogenicum, as Species of the Mycobacterium terrae Complex Causing Tenosynovitis and Osteomyelitis

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