[Tuberculous septic polyarthritis caused by Mycobacterium bovis].
Infections due to Mycobacterium bovis have become uncommon. We report a case with polyarthritis and cutaneous nodules suggesting a rheumatic disease. This 61 year old male under corticosteroid therapy for asthma developed febrile arthritis of the right wrist and cutaneous nodules that resolved rapidly under treatment with penicillin M and an aminoglycoside. Six months later, he developed arthritis of the right wrist and both elbows, as well as infection of a right hip prosthesis. The left wrist and left knee were then affected concomitantly. The cutaneous nodules recurred. A giant cell granuloma without caseous necrosis was found upon examination of a biopsy specimen from a nodule. Granulomatous lesions with caseous necrosis were seen in a specimen of synovial membrane from the right wrist. Antituberculous treatment ensured resolution of the arthritides and nodules but failed to prevent loosening of the hip prosthesis. Acid-fast bacilli were found in the specimens taken during removal of the prosthesis. After three months, cultures of synovial membrane specimens from the knee grew Mycobacterium bovis.
Unité d'Immunologie Clinique, Hôpital Gabriel Montpied, Clermont-Ferrand.
J J
JJ
Dubost
M
M
Soubrier
J
J
Schmidt
T
T
Oualid
B
B
Sauvezie
D001170:Arthritis, Infectious / Q000382:microbiology; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009163:Mycobacterium bovis; D014394:Tuberculosis, Osteoarticular / Q000382:microbiology
Polyarthrite septique tuberculeuse à Mycobacterium bovis.