Coexistence of oligo-articular gout and Mycobacterium kansasii joint and bursal infection in a patient with an orthotopic heart transplant.
Mycobacterium kansasii septic arthritis is rare, most often occurring in immunosuppressed patients including those with organ transplants. We present a case of oligoarticular M. kansasii infection in bilateral ankles, knee, and bilateral olecranon bursae in coexistence with tophaceous gouty arthropathy in a heart transplant patient. There are no reports of M. kansasii infection occurring in joints also affected by tophaceous gout. We contend that gouty arthropathy may alter the joint in such a way as to increase the risk of development of this infection in patients already at risk. In transplant patients presenting with a history and pattern of arthritis consistent with gout, a sufficient level of suspicion should be maintained for this infectious complication, even if monosodium urate crystals are seen on joint aspiration.
Baker
J F
JF
Department of Medicine, University of Pennsylvania, Philadelphia, 19104, USA. bakerjo@uphs.upenn.edu
Stonecypher
M
M
D000328:Adult; D000843:Ankle Joint; D000995:Antitubercular Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications* / Q000382:microbiology; D002061:Bursa, Synovial / Q000382:microbiology; D004359:Drug Therapy, Combination; D004551:Elbow Joint; D006073:Gout / Q000150:complications*; D016027:Heart Transplantation; D006801:Humans; D007719:Knee Joint; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D019909:Mycobacterium kansasii / Q000302:isolation & purification; D011183:Postoperative Complications
D000995:Antitubercular Agents