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 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.
Bernard
L
L
Service des Maladies Infectieuses et Tropicales, Hôpital Universitaire Raymond-Poincaré, 92380 Garches Cedex, France. l.bernard@rpc.ap-hop-paris.fr.
Vincent
V
V
Lortholary
O
O
Raskine
L
L
Vettier
C
C
Colaitis
D
D
Mechali
D
D
Bricaire
F
F
Bouvet
E
E
Sadr
F B
FB
Lalande
V
V
Perronne
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007596:Joints / Q000382:microbiology / Q000473:pathology; D016030:Kidney Transplantation; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D019909:Mycobacterium kansasii / Q000187:drug effects / Q000302:isolation & purification*; D011565:Psoriasis / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D013582:Synovial Fluid / Q000382:microbiology; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents