title: A case of wrist tenosynovitis caused by Mycobacterium kansasii in a renal transplant recipient.
abstract: Mycobacterial infection in an organ transplant recipient is a diagnostic and therapeutic challenge. Diagnosis is often delayed, resulting in significant morbidity. Anti-microbial chemotherapy needs careful selection to prevent potentially significant complications, such as organ rejection and dose-related toxicities. We present the case of a 61-year-old Caucasian male kidney transplant recipient with chronic tenosynovitis of the left wrist. Histological findings of the synovial biopsy revealed multinucleated giant cell epithelioid granuloma. Culture of synovial fluid grew Mycobacterium kansasii. Treatment with rifampicin, ethambutol, and clarithromycin proved curative, but the patient developed irreversible ethambutol-related optic neuritis.
authors: Department of Renal Medicine, Broomfield Hospital, Mid Essex Hospitals, NHS Trust, Chelmsford, UK. anthony.chan@meht.nhs.uk
authors: A
authors: A
authors: Chan
authors: A
authors: A
authors: Findlay
authors: S
authors: S
authors: Abeygunasekara
mesh_terms: D017291:Clarithromycin / Q000627:therapeutic use; D004977:Ethambutol / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D019909:Mycobacterium kansasii / Q000187:drug effects / Q000302:isolation & purification*; D009902:Optic Neuritis / Q000139:chemically induced; D012293:Rifampin / Q000627:therapeutic use; D013717:Tenosynovitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D014953:Wrist
chemical_list: D004977:Ethambutol; D017291:Clarithromycin; D012293:Rifampin