title: Synovitis of the wrist caused by Mycobacterium florentinum.
abstract: Mycobacterium florentinum is a newly identified, rare, slow-growing species of nontuberculous mycobacteria (NTM). Here, we report a case of M. florentinum-induced synovitis of the wrist in an immunocompromised Japanese patient. M. florentinum was identified by sequence analysis of the rpoB, hsp65, and 16S rRNA genes. The M. florentinum strain in this study could not be differentiated from certain M. triplex strains by the hsp65 or 16S rRNA sequences alone, because they occasionally shared more than 99 % sequence identity. The isolated M. florentinum strain was only susceptible to clarithromycin and amikacin. Initially, the patient was treated with clarithromycin, levofloxacin, and ethambutol, and then with clarithromycin, levofloxacin, and rifampicin. To our knowledge, M. florentinum-induced synovitis has not been previously reported. Our results suggest that, in addition to other well-known pathogenic NTM, the recently identified M. florentinum strain should be considered as a possible cause of synovitis. Moreover, we should be cautious when identifying M. florentinum because this strain closely resembles M. triplex in genotype.
authors.affiliation: Department of Infection Control and Prevention, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Nukui
authors.forename: H
authors.initials: H
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Ishioka
authors.forename: H
authors.initials: H
authors.lastname: Miyamoto
authors.forename: A
authors.initials: A
authors.lastname: Okamoto
authors.forename: Y
authors.initials: Y
authors.lastname: Kazumi
authors.forename: H
authors.initials: H
authors.lastname: Yotsuyanagi
authors.forename: K
authors.initials: K
authors.lastname: Moriya
authors.forename: S
authors.initials: S
authors.lastname: Hatakeyama
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007564:Japan; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology*; D009170:Nontuberculous Mycobacteria / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D012329:RNA, Bacterial / Q000235:genetics; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D013585:Synovitis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology*; D014953:Wrist / Q000382:microbiology* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S