title: Mycobacterium avium complex (MAC) osteomyelitis and septic arthritis in an immunocompetent host.
abstract: We describe a case of Mycobacterium avium complex (MAC) osteomyelitis and septic arthritis in an immunocompetent man. Infection was derived from a chainsaw injury sustained on the lateral aspect of the ankle 13 years earlier, and had spread through the bone, joint and soft tissue emerging at the medial aspect. This was successfully treated with surgical debridement, drainage, arthrodesis and 18 months of chemotherapy consisting of clarithromycin, rifampicin, ethambutol, and ciprofloxacin with an initial 2 weeks of amikacin. Infections with this organisms are generally associated with immunocompromised states, particularly advanced AIDS. However, our patient illustrates that atypical mycobacterial infections must also be considered in immunocompetent patients who have a prolonged clinical course and an appropriate potential source of infection.
authors.affiliation: University of Queensland Department of Medicine and Infectious Diseases, Mater Misericordiae Hospital, South Brisbane, Australia.
authors.forename: A R
authors.initials: AR
authors.lastname: Jones
authors.forename: J
authors.initials: J
authors.lastname: Bartlett
authors.forename: J G
authors.initials: JG
authors.lastname: McCormack
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000382:microbiology*; D003646:Debridement; D006801:Humans; D007121:Immunocompetence; D008297:Male; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy; D010019:Osteomyelitis / Q000188:drug therapy / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents