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      Septic Arthritis of the Right Wrist Due to Mycobacterium avium Complex in an Immunocompetent Patient

      case-report
      Author(s): 1 , 1 , 1 , 2 ,
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: mycobacterium avium intracellulare, mycobacterium avium complex, septic arthritis, case report, non-tuberculous mycobacterium

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          Abstract

          Septic arthritis due to Mycobacterium avium complex (MAC) is extremely rare. While MAC infection is classically associated with HIV/AIDS and immunosuppressed states, it may occur in immunocompetent individuals. We report a case of MAC septic arthritis of a native wrist joint in an immunocompetent host. The diagnosis of septic arthritis due to MAC is commonly delayed and initially misdiagnosed, warranting a high level of suspicion to make an accurate and timely diagnosis. Suspecting the diagnosis when there are atypical features present in the clinical history may be crucial in identifying affected patients.

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          Most cited references14

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          Mycobacterium avium Complex Disease

          Charles Daley (2017)
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            Mycobacterial Musculoskeletal Infections.

            John Hogan, Rocío Hurtado, Sandra B Nelson (2017)
            Although less common as causes of musculoskeletal infection than pyogenic bacteria, both Mycobacterium tuberculosis and nontuberculous mycobacteria can infect bones and joints. Although tuberculous arthritis and osteomyelitis have been recognized for millennia, infections caused by nontuberculous mycobacteria are being identified more often, likely because of a more susceptible host population and improvements in diagnostic capabilities. Despite advances in modern medicine, mycobacterial infections of the musculoskeletal system remain particularly challenging to diagnose and manage. This article discusses clinical manifestations of musculoskeletal infections caused by Mycobacterium tuberculosis and nontuberculous mycobacteria. Pathogenesis, unique risk factors, and diagnostic and therapeutic approaches are reviewed.
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              Mycobacterium avium-intracellulare cellulitis occurring with septic arthritis after joint injection: a case report

              David Murdoch, Jay McDonald (2007)
              Background Cellulitis caused by Mycobacterium avium-intracellulare has rarely been described. Mycobacterium avium-intracellulare is a rare cause of septic arthritis after intra-articular injection, though the causative role of injection is difficult to ascertain in such cases. Case presentation A 57-year-old with rheumatoid arthritis treated with prednisone and azathioprine developed bilateral painful degenerative shoulder arthritis. After corticosteroid injections into both acromioclavicular joints, he developed bilateral cellulitis centered over the injection sites. Skin biopsy showed non-caseating granulomas, and culture grew Mycobacterium avium-intracellulare. Joint aspiration also revealed Mycobacterium avium-intracellulare infection. Conclusion Although rare, skin and joint infections caused by Mycobacterium avium-intracellulare should be considered in any immunocompromised host, particularly after intra-articular injection. Stains for acid-fast bacilli may be negative in pathologic samples even in the presence of infection; cultures of tissue specimens should always be obtained.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 12 August 2021
                Publication date (Electronic, collection): August 2021
                Volume: 13
                Issue: 8
                Electronic Location Identifier: e17129
                Affiliations
                [1 ] Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, USA
                [2 ] Rheumatology, Pali Momi Medical Center, Aiea, USA
                Author notes
                Article
                DOI: 10.7759/cureus.17129
                PMC ID: 8436997
                SO-VID: a9d309e3-ea82-4297-a983-e0db7fcd7d24
                Copyright © Copyright © 2021, Saha et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 12 August 2021
                Categories
                Subject: Internal Medicine
                Subject: Infectious Disease
                Subject: Rheumatology

                Keywords: mycobacterium avium intracellulare,mycobacterium avium complex,septic arthritis,case report,non-tuberculous mycobacterium
                Data availability:
                Keywords: mycobacterium avium intracellulare, mycobacterium avium complex, septic arthritis, case report, non-tuberculous mycobacterium

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