Mycobacterium marinum arthritis.
Mycobacterium marinum is an atypical acid-fast organism that is rarely associated with septic arthritis. Most often this is seen in patients with monarticular synovitis of the hands or wrists, especially in association with a history of periarticular trauma or exposure to marine environments. From tissue obtained by aspiration or synovectomy, Mycobacterium marinum can be identified by Ziehl-Nielson stain and has optimal growth in Lowenstein-Jenson medium. Therapy should consist of at least two antimycobacterial agents for a minimum 6 months. Surgical debridement also may be beneficial. The clinician must have a high index of suspicion that exposure to Mycobacterium marinum has occurred so appropriate stains and cultures can be obtained and antimycobacterial therapy initiated.
Alloway
J A
JA
Department of Internal Medicine, Malcolm Grow Medical Center, Andrews Air Force Base, MD 20331, USA.
Evangelisti
S M
SM
Sartin
J S
JS
D000368:Aged; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000188:drug therapy; D009170:Nontuberculous Mycobacteria