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Infectious Disorders - Drug Targets

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ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

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Case Report

Mycobacterium flavescens Infection - An Unusual Case of Prosthetic Joint Infection

Author(s): Peter Holleb*, Srijisnu De and Suresh Antony

Volume 24, Issue 5, 2024

Published on: 17 January, 2024

Article ID: e170124225744 Pages: 6

DOI: 10.2174/0118715265274138231229070757

Price: $65

Abstract

Introduction: The onset of prosthetic joint infections (PJIs) is characterized by early onset defined as within 90 days of the procedure, delayed onset defined as within 3 to 12 months, and late onset defined as over 12 months. In only a scant number of case reports, Mycobacterium flavescens associated infections are typically found in sputum cultures and associated with various forms of penetrating joint traumas, particularly post-surgical interventions. Due to its rarity in presentation among cases of PJIs, we have presented a case of PJI caused by Mycobacterium flavescens.

Case Presentation: We have, herein, reported a case of a 70-year-old male presenting with stabbing left knee pain over the past several months along with accompanying erythema and swelling with the presence of purulent discharge. Outpatient cultures have shown the growth of Mycobacterium flavescent; subsequently, the patient underwent a 2-stage revision arthroplasty and was treated with a three-drug regimen and implant 5 months later. Although being an atypical cause of PJIs, we emphasize the importance of considering NTM as a differential for immunocompromised patients, especially those with prior surgical intervention.

Discussion: Mycobacterium spp. related PJIs manifest clinical features similar to other bacteriacausing PJIs, such as warm, indurated edema at the surgical site resulting in wound dehiscence and joint effusion. Diagnosis of Mycobacterium spp. related PJIs includes history and physical examination findings, serum inflammatory markers, synovial fluid analysis, and culture. Concurrently with surgical interventions, utilization of antimicrobial agents provides additional control in Mycobacterium- related PJI. Mycobacterium flavescens should be included among other NTMs as a possible cause of PJIs.

Graphical Abstract

[1]
Sloan M, Premkumar A, Sheth NP. Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am 2018; 100(17): 1455-60.
[http://dx.doi.org/10.2106/JBJS.17.01617] [PMID: 30180053]
[2]
Jitmuang A, Yuenyongviwat V, Charoencholvanich K, Chayakulkeeree M. Rapidly-growing mycobacterial infection: A recognized cause of early-onset prosthetic joint infection. BMC Infect Dis 2017; 17(1): 802.
[http://dx.doi.org/10.1186/s12879-017-2926-3] [PMID: 29281992]
[3]
Poilvache H, Van Cauter M, Coquay J, Rodriguez-Villalobos H, Yombi JC, Cornu O. Delayed total hip arthroplasty infection with Mycobacterium Tuberculosis complex. Acta Orthop Belg 2020; 86(2): 249-52.
[PMID: 33418615]
[4]
Meyssonnier V, Zeller V, Malbos S, et al. Prosthetic joint infections due to mycobacterium tuberculosis: A retrospective study. Joint Bone Spine 2019; 86(2): 239-43.
[http://dx.doi.org/10.1016/j.jbspin.2018.09.008] [PMID: 30266444]
[5]
Parrish N. An update on mycobacterial taxonomy, 2016-2017. J Clin Microbiol 2019; 57(5): e01408-18.
[http://dx.doi.org/10.1128/JCM.01408-18] [PMID: 30602442]
[6]
Fischer PR, Christenson JC, Pavia AT, Orme GA. Postoperative mycobacterium flavescens infection in a Child. Infect Dis Clin Pract 1997; 6(4): 263-4.
[http://dx.doi.org/10.1097/00019048-199705000-00014]
[7]
Ottink KD, Strahm C, Muller-Kobold A, Sendi P, Wouthuyzen-Bakker M. Factors to consider when assessing the diagnostic accuracy of synovial leukocyte count in periprosthetic joint infection. J Bone Jt Infect 2019; 4(4): 167-73.
[http://dx.doi.org/10.7150/jbji.34854] [PMID: 31555502]
[8]
Esteban J, García-Coca M. Mycobacterium biofilms. Front Microbiol 2018; 8: 2651.
[http://dx.doi.org/10.3389/fmicb.2017.02651] [PMID: 29403446]
[9]
Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med 2004; 351(16): 1645-54.
[http://dx.doi.org/10.1056/NEJMra040181] [PMID: 15483283]
[10]
Peng SH, Lee SH, Chen CC, et al. Nontuberculous mycobacteria peri-prosthetic joint infection: An outcome analysis for two stage revision arthroplasty. J Orthop Surg 2022; 30(3)
[http://dx.doi.org/10.1177/10225536221140610] [PMID: 36396130]
[11]
Maderazo EG, Judson S, Pasternak H. Late infections of total joint prostheses. A review and recommendations for prevention. Clin Orthop Relat Res 1988; (229): 131-42.
[PMID: 3280197]
[12]
Iqbal F, Noor SS, Najjad KR, Ishaque S, Memon N, Zano S. The unusual cause of prosthetic joint infection: Outcomes of nontuberculous mycobacteria treatment following primary total knee arthroplasty. Clin Orthop Surg 2022; 14(4): 507-13.
[http://dx.doi.org/10.4055/cios21085] [PMID: 36518927]
[13]
Caravedo Martinez MA, Blanton LS. Mycobacterium mageritense prosthetic joint infection. Case Rep Infect Dis 2020; 2020: 1-3.
[http://dx.doi.org/10.1155/2020/8845430] [PMID: 32733720]
[14]
Dobos K, Suh GA, Tande AJ, Kappagoda S. Prosthetic joint infections caused by Mycobacterium avium complex: a series of five cases. J Bone Jt Infect 2022; 7(4): 137-41.
[http://dx.doi.org/10.5194/jbji-7-137-2022] [PMID: 35855286]
[15]
Parvizi J, Zmistowski B, Berbari EF, et al. New definition for periprosthetic joint infection: From the Workgroup of the Musculoskeletal Infection Society. Clin Orthop Relat Res 2011; 469(11): 2992-4.
[http://dx.doi.org/10.1007/s11999-011-2102-9] [PMID: 21938532]
[16]
Maimaiti Z, Li Z, Xu C, et al. Non-Tuberculosis mycobacterium periprosthetic joint infections following total hip and knee arthroplasty: Case series and review of the literature. Orthop Surg 2023; 15(6): 1488-97.
[http://dx.doi.org/10.1111/os.13661] [PMID: 37154097]
[17]
Santoso A, Phatama KY, Rhatomy S, Budhiparama NC. Prosthetic joint infection of the hip and knee due to Mycobacterium species: A systematic review. World J Orthop 2022; 13(5): 503-14.
[http://dx.doi.org/10.5312/wjo.v13.i5.503] [PMID: 35633748]
[18]
Ribeiro AF, Inacio Oliveira M, Jordão P, Tavares D, Varandas L, Gouveia C. Mycobacterium tuberculosis prosthesis joint infection. Pediatr Int 2020; 62(1): 97-9.
[http://dx.doi.org/10.1111/ped.14037] [PMID: 31916331]
[19]
Patel A, Elzweig J. Mycobacterium bovis prosthetic joint infection following intravesical instillation of BCG for bladder cancer. BMJ Case Rep 2019; 12(12): e231830.
[http://dx.doi.org/10.1136/bcr-2019-231830] [PMID: 31857290]
[20]
Sixt T, Bador J, Amoureux L, Piroth L, Blot M. Prosthetic joint infection caused by Mycobacterium avium complex. QJM 2020; 113(4): 278-9.
[http://dx.doi.org/10.1093/qjmed/hcz306] [PMID: 31764970]
[21]
Barry M, Akkielah L, Askar MA, Bin Nasser AS. Miliary tuberculosis with delayed-onset total knee arthroplasty Mycobacteria tuberculosis infection successfully treated with medical therapy alone: A case report and literature review. Knee 2019; 26(5): 1152-8.
[http://dx.doi.org/10.1016/j.knee.2019.07.010] [PMID: 31427242]
[22]
Goldstein N, St Clair JB, Kasperbauer SH, Daley CL, Lindeque B. Nontuberculous mycobacterial musculoskeletal infection cases from a tertiary referral center, colorado, USA. Emerg Infect Dis 2019; 25(6): 1075-83.
[http://dx.doi.org/10.3201/eid2506.181041] [PMID: 31107224]
[23]
Buser GL, Laidler MR, Cassidy PM, Moulton-Meissner H, Beldavs ZG, Cieslak PR. Outbreak of nontuberculous mycobacteria joint prosthesis infections, oregon, USA, 2010-2016. Emerg Infect Dis 2019; 25(5): 849-55.
[http://dx.doi.org/10.3201/eid2505.181687] [PMID: 31002056]
[24]
Spanyer JM, Foster S, Thum-DiCesare JA, Kwon YM, Burke DW, Nelson SB. Mycobacterium abscessus: A rare cause of periprosthetic knee joint infection. Am J Orthop 2018; 47.
[25]
Chang CH, Hu CC, Chang Y, Hsieh PH, Shih HN, Ueng SWN. Two-stage revision arthroplasty for mycobacterium tuberculosis periprosthetic joint infection: An outcome analysis. PLoS One 2018; 13(9): e0203585.
[http://dx.doi.org/10.1371/journal.pone.0203585] [PMID: 30192830]
[26]
Metayer B, Menu P, Khatchatourian L, Preuss P, Dauty M, Fouasson-Chailloux A. Prosthetic joint infection with pseudo-tumoral aspect due to Mycobacterium bovis infection after Bacillus-Calmette-Guerin therapy. Ann Phys Rehabil Med 2018; 61(1): 62-4.
[http://dx.doi.org/10.1016/j.rehab.2017.08.001] [PMID: 28890342]
[27]
Haris M, Alolayan SS. Total knee prosthesis infected with Mycobacterium tuberculosis. BMJ Case Rep 2017; 2017
[28]
Kim M, Ha CW, Jang JW, Park YB. Rapidly growing non-tuberculous mycobacteria infection of prosthetic knee joints: A report of two cases. Knee 2017; 24(4): 869-75.
[http://dx.doi.org/10.1016/j.knee.2017.04.015] [PMID: 28551202]
[29]
Henry MW, Miller AO, Kahn B, Windsor RE, Brause BD. Prosthetic joint infections secondary to rapidly growing mycobacteria: Two case reports and a review of the literature. Infect Dis 2016; 48(6): 453-60.
[http://dx.doi.org/10.3109/23744235.2016.1142673] [PMID: 27030918]
[30]
Jeong JH, Seo YH, Kim KH, Ahn JY, Park PH, Park YK. Mycobacterium wolinskyi infection confirmed by rpoB gene sequencing. J Clin Lab Anal 2012; 26(5): 325-7.
[http://dx.doi.org/10.1002/jcla.21526] [PMID: 23001976]
[31]
Lee RP, Cheung KW, Chiu KH, Tsang ML. Mycobacterium chelonae infection after total knee arthroplasty: a case report. J Orthop Surg 2012; 20(1): 134-6.
[http://dx.doi.org/10.1177/230949901202000130] [PMID: 22535831]
[32]
Wang SX, Yang CJ, Chen YC, Lay CJ, Tsai CC. Septic arthritis caused by Mycobacterium fortuitum and Mycobacterium abscessus in a prosthetic knee joint: Case report and review of literature. Intern Med 2011; 50(19): 2227-32.
[http://dx.doi.org/10.2169/internalmedicine.50.5610] [PMID: 21963746]
[33]
Ahmad S, Khakoo RA. Left knee prosthesis-related Mycobacterium goodii infection. Int J Infect Dis 2010; 14(12): e1115-6.
[http://dx.doi.org/10.1016/j.ijid.2010.02.2245] [PMID: 21071255]
[34]
Gupta A, Clauss H. Prosthetic joint infection with Mycobacterium avium complex in a solid organ transplant recipient. Transpl Infect Dis 2009; 11(6): 537-40.
[http://dx.doi.org/10.1111/j.1399-3062.2009.00433.x] [PMID: 19656344]
[35]
Porat MD, Austin MS. Bilateral knee periprosthetic infection with mycobacterium fortuitum. J Arthroplasty 2008; 23(5): 787-9.
[http://dx.doi.org/10.1016/j.arth.2007.07.010] [PMID: 18534520]
[36]
Reigstad O, Siewers P. A total hip replacement infected with mycobacterium bovis after intravesicular treatment with Bacille-Calmette-Guérin for bladder cancer. J Bone Joint Surg Br 2008; 90-B(2): 225-7.
[http://dx.doi.org/10.1302/0301-620X.90B2.20038] [PMID: 18256093]
[37]
Brown A, Grubbs P, Mongey AB. Infection of total hip prosthesis by Mycobacterium tuberculosis and Mycobacterium chelonae in a patient with rheumatoid arthritis. Clin Rheumatol 2008; 27(4): 543-5.
[http://dx.doi.org/10.1007/s10067-007-0788-6] [PMID: 18034202]
[38]
Cheung I, Wilson A. Mycobacterium fortuitum infection following total knee arthroplasty: A case report and literature review. Knee 2008; 15(1): 61-3.
[http://dx.doi.org/10.1016/j.knee.2007.08.007] [PMID: 17869520]
[39]
Eid AJ, Berbari EF, Sia IG, Wengenack NL, Osmon DR, Razonable RR. Prosthetic joint infection due to rapidly growing mycobacteria: Report of 8 cases and review of the literature. Clin Infect Dis 2007; 45(6): 687-94.
[http://dx.doi.org/10.1086/520982] [PMID: 17712751]
[40]
Segal A, Krauss ES. Infected total hip arthroplasty after intravesical bacillus Calmette-Guérin therapy. J Arthroplasty 2007; 22(5): 759-62.
[http://dx.doi.org/10.1016/j.arth.2006.07.010] [PMID: 17689788]
[41]
Khater FJ, Samnani IQ, Mehta JB, Moorman JP, Myers JW. Prosthetic joint infection by Mycobacterium tuberculosis: An unusual case report with literature review. South Med J 2007; 100(1): 66-9.
[http://dx.doi.org/10.1097/01.smj.0000232972.50186.4c] [PMID: 17269530]
[42]
Pulcini C, Vandenbussche E, Podglajen I, et al. Hip prosthesis infection due to Mycobacterium wolinskyi. J Clin Microbiol 2006; 44(9): 3463-4.
[http://dx.doi.org/10.1128/JCM.02685-05] [PMID: 16954303]

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