Tenosynovitis caused by <i><scp>M</scp>ycobacterium malmoense</i> in two kidney transplant recipients and review of the literature

Grootveld, Rebecca van; Scherer, Hans Ulrich; Peters, Elke E.M.; Gaasbeek, André; Arend, Sandra M.; Wunderink, Herman F.

doi:10.1111/tid.12810

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…14 In contrast to other NTM, only 20% of infections by M malmoense are extrapulmonary, such as cervical lymphadenitis and tenosynovitis. 6,15 To our knowledge, the present case is the first case describing M chimaera infection in a KTR. M chimaera was first described in 2004 by Tortoli, as new specie included in the MAC.…”

Section: Discussionmentioning

confidence: 66%

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Coinfection of Mycobacterium malmoense and Mycobacterium chimaera in a kidney transplant recipient: A case report and review of the literature

Maalouly

Devresse

Martin

et al. 2020

Transplant Infectious Dis

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Nontuberculous mycobacteria (NTM) are ubiquitous organisms found in soil and water. Solid organ recipients are at increased risk of NTM infections due to impaired immunity.Although the NTM infections rate is low, it increases morbidity and the risk of mortality.Diagnosis is often delayed because of the lack of specific clinical symptoms and requires a high index of suspicion. Management may be challenging: long-term treatment with risks of side effects and interactions with immunosuppressive regimen; reduction of immunosuppression; and risk of allograft rejection. Prognosis is widely variable. We report the first case of Mycobacterium malmoense chest infection with concomitant Mycobacterium chimaera urinary tract infection in a kidney transplant recipient. The evolution was marked by poor tolerance of the treatment with severe adverse events and disabled functional status. K E Y W O R D Skidney transplantation, Mycobacterium chimaera, Mycobacterium malmoense, nontuberculous mycobacteria, solid organ transplant

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Section: Discussionmentioning

confidence: 66%

“…Interestingly, one of the patients in this study was a KTR and had a contact with another patient immunocompetent suffering from M malmoense infection . In contrast to other NTM, only 20% of infections by M malmoense are extrapulmonary, such as cervical lymphadenitis and tenosynovitis …”

Section: Discussionmentioning

confidence: 90%

Coinfection of Mycobacterium malmoense and Mycobacterium chimaera in a kidney transplant recipient: A case report and review of the literature

Maalouly

Devresse

Martin

et al. 2020

Transplant Infectious Dis

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“…We present an extremely rare clinical case of M. malmoense tenosynovitis, occurring in parallel with polyarthritis. Unlike the two other rheumatologic patients suffering from M. malmoense tenosynovitis described in the literature [ 5 , 7 ], our patient had no immunosuppressive treatment. The rapid relapse of tenosynovitis after the first and second tenosynovectomy is also unusual, as this bacterium is a slow-growing NTM species.…”

Section: Discussionmentioning

confidence: 88%

“…The main extrapulmonary disease is cervical lymphadenitis in children. Isolated tenosynovitis is an extremely rare manifestation, with only 11 cases described in the literature [ 5 ]. Out of these 11 patients, only two had a previous inflammatory rheumatic disease and, unlike our patient, they were both on immunosuppressive therapy prior to the infection.…”

Section: Introductionmentioning

confidence: 99%

A refractory tenosynovitis of the wrist: a case report

2022

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Background Mycobacterium malmoense is a species of slow-growing nontuberculous mycobacteria. It causes mostly pulmonary infections or lymphadenitis in children, but is increasingly encountered in isolated tenosynovitis in adults. Diagnosis is often delayed because of the rarity of the condition and the difficulty of culturing the bacteria. Case presentation We report on a rare association of seronegative polyarthritis with infectious nontuberculous mycobacteria tenosynovitis. A 65-year-old Caucasian female was referred to our clinic because of persisting tenosynovitis of the finger flexor tendons of her right hand, despite two previous synovectomies. She also reported bilateral shoulder and left wrist pain. Paraclinical investigations showed slightly elevated inflammatory parameters. Ultrasound showed synovitis of metacarpophalangeal joints of the right hand and right knee, and a bilateral subacromial bursitis. Hand magnetic resonance imaging also revealed an erosive carpal synovitis. Bacteriological analysis of the second tenosynovectomy specimen showed no growths in aerobic and anaerobic cultures. An additional synovial fluid analysis of the wrist joint was negative for mycobacteria and crystals. Seronegative polyarthritis was suspected, but the initiated immunosuppressive treatment with prednisolone and methotrexate resulted in no clinical improvement of the tenosynovitis. Yet the other joints responded well, and the inflammatory parameters normalized. The immunosuppression was later stopped because of side effects. Due to massive worsening of the tenosynovitis, a third synovectomy was performed. Mycobacterium malmoense was identified on biopsy, leading to the diagnosis of infectious tenosynovitis. At this point, we started an antituberculous therapy, with incomplete response. A combination of antimicrobial and immunosuppressive treatment finally led to the desired clinical improvement. Conclusion The treatment of nontuberculous mycobacteria tenosynovitis is not well established, but combining antibiotics with surgical debridement is probably the most adequate approach. Our case highlights the importance of having a high clinical suspicion of an atypical infection in patients with inflammatory tenosynovitis not responding to usual care.

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“…Mycobacterium malmoense is known as a slow-growing nontuberculous mycobacterium (NTM) and leads to human infection mainly among patients who are suffering from cellular immunity conditions [1] Although M. Malmoense mainly causes pulmonary infections, but extra pulmonary infections including cervical lymphadenitis and tenosynovitis are likely to exist [2]. M.malmoense is considered as an atypical mycobacterial strain that has been discovered in Sweden since 1954 [3] although the incidence of M. malmoenseis still rare, it has been shown to increase since the 1980s [4].…”

Section: Introductionmentioning

confidence: 99%

The Radiographic Features of Mycobacterium Malmoense Infection

Heis¹

2018

BJSTR

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Mycobacterium malmoense is a rare infection with increasing prevalence since its first reported cases. It is not easy to be diagnosed. The objective of this study was to report our experience in managing this infection. A total of 24 cases were included from Jordan and United Arab Emirates. Our finding showed that in M. malmoense thick-walled cavitating lesions are common especially in the upper lobes. In our series, there was almost equal distribution of unilateral and bilateral disease. Underlying fibrosis was commonly present with pleural effusions rarely seen. Middle and lower lobe involvement was rare. The findings show the diverse range of radiological appearances seen in patients with nontuberculous mycobacterial infections. Taken together, although the appearances are non-specific, an awareness of the varied presentations of these infections is important in order to expedite the correct diagnosis and the commencement of appropriate therapy.

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Tenosynovitis caused by Mycobacterium malmoense in two kidney transplant recipients and review of the literature

Cited by 6 publications

References 22 publications

Coinfection of Mycobacterium malmoense and Mycobacterium chimaera in a kidney transplant recipient: A case report and review of the literature

Coinfection of Mycobacterium malmoense and Mycobacterium chimaera in a kidney transplant recipient: A case report and review of the literature

A refractory tenosynovitis of the wrist: a case report

The Radiographic Features of Mycobacterium Malmoense Infection

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