Mycobacterium kansasii Septic Arthritis: French Retrospective Study of 5 Years and Review

Septic arthritis due to Mycobacterium kansasii is rare; only 40 cases have been published. A French national inquiry revealed the occurrence of 10 new cases between 1992 and 1997 (8 men and 2 women: mean age, 37 years; range, 25–54 years). Seven had an underlying condition: AIDS (n =4), chronic skin...

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Bibliographic Details
Published in:Clinical infectious diseases 1999-12, Vol.29 (6), p.1455-1460
Main Authors: Bernard, L., Vincent, V., Lortholary, O., Raskine, L., Vettier, C., Colaitis, D., Mechali, D., Bricaire, F., Bouvet, E., Bani Sadr, F., Lalande, V., Perronne, C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
AIDS
AIDS/HIV
Anti-Bacterial Agents - pharmacology
Anti-Bacterial Agents - therapeutic use
Arthritis
Arthritis, Infectious - complications
Arthritis, Infectious - drug therapy
Arthritis, Infectious - microbiology
Bacterial arthritis and osteitis
Bacterial diseases
Biological and medical sciences
Clinical Articles
Female
France
Fungal diseases
Fungal infections
HIV
HIV Infections - complications
Human bacterial diseases
Humans
Infections
Infectious diseases
Joint diseases
Joints
Joints - microbiology
Joints - pathology
Kidney Transplantation
Male
Medical sciences
Microbial Sensitivity Tests
Middle Aged
Mycobacterium Infections, Nontuberculous - complications
Mycobacterium Infections, Nontuberculous - drug therapy
Mycobacterium Infections, Nontuberculous - microbiology
Mycobacterium kansasii
Mycobacterium kansasii - drug effects
Mycobacterium kansasii - isolation & purification
Psoriasis - complications
Retrospective Studies
Risk Factors
Synovial Fluid - microbiology
Treatment Outcome
Wrist
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Summary:Septic arthritis due to Mycobacterium kansasii is rare; only 40 cases have been published. A French national inquiry revealed the occurrence of 10 new cases between 1992 and 1997 (8 men and 2 women: mean age, 37 years; range, 25–54 years). Seven had an underlying condition: AIDS (n =4), chronic skin psoriasis and AIDS (n = 2), or a renal transplant (n = 1). Trauma to the joint, use of intra-articular corticosteroid(s) 1 month to 2 years after the event, and chronic skin psoriasis were risk factors. The mean interval between appearance of the first symptoms of arthritis and the diagnosis was 5 months. Monarthritis was localized to the knee (n = 4), wrist (n = 3), finger (n = 1), elbow (n = 1), or ankle (n = 1). The main diagnostic procedure was culture of a synovial biopsy specimen. In all cases, debridement was associated with antimycobacterial treatment. Three patients died of AIDS during treatment, and another is still undergoing treatment; the other 6 patients were cured. M. kansasii infection should be considered in all cases of indolent arthritis with any of the following risk factors: local trauma, local or systemic corticosteroid therapy, chronic skin psoriasis, and immunodepression, especially that due to human immunodeficiency virus infection.
ISSN:1058-4838
1537-6591
DOI:10.1086/313519