[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.
Dubost
J J
JJ
Unité d'Immunologie Clinique, Hôpital Gabriel Montpied, Clermont-Ferrand.
Soubrier
M
M
Schmidt
J
J
Oualid
T
T
Sauvezie
B
B
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.