Tuberculous pyomyositis in a rheumatoid arthritis patient treated with anakinra.
Musculoskeletal tuberculosis (TB) occurs in only 3% of patients with TB while tuberculous pyomyositis is rare. It usually affects immunocompromised or patients with underlying comorbidities. We present a case of tuberculous pyomyositis in a 85-year-old Caucasian patient with rheumatoid arthritis (RA) treated with steroids and anakinra. The patient presented with fever as well as redness, swelling and induration on the lateral side of the hip and thigh. Under ultrasound guidance fluid collection of the thigh was aspirated. Polymerase chain reaction (PCR) and cultures of the fluid were positive for Mycobacterium TB. The patient underwent bronchoscopy. PCR and cultures from the bronchoalveolar lavage were also positive for Mycobacterium TB. The patient was treated with anti TB treatment with amelioration of the inflammation in the hip and thigh. This is the first reported case of tuberculous pyomyositis in a RA patient treated with anakinra.
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Michael P
MP
Migkos
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
George A
GA
Somarakis
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Theodora E
TE
Markatseli
Pulmonary Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Maria
M
Matthaiou
Department of Clinical Imaging and Radiology, Medical School, University of Ioannina, Ioannina, Greece.
Paraskevi
P
Kosta
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Paraskevi V
PV
Voulgari
Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
Alexandros A
AA
Drosos
D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D053590:Interleukin 1 Receptor Antagonist Protein / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D052880:Pyomyositis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology
D018501:Antirheumatic Agents; D000995:Antitubercular Agents; D053590:Interleukin 1 Receptor Antagonist Protein