A case report of wrist synovial infection due to Mycobacterium jacuzzii , Iran
- PDF / 683,239 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 7 Downloads / 164 Views
CASE REPORT
Open Access
A case report of wrist synovial infection due to Mycobacterium jacuzzii, Iran Fatemeh Sakhaee1, Morteza Masoumi1, Farzam Vaziri1,2, Seyed Davar Siadat1,2 and Abolfazl Fateh1,2*
Abstract Background: Mycobacterium jacuzzii (M. jacuzzii) was first isolated in 2003 by insertion of breast implants in Tel Aviv, Israel. In this case report, we describe our experience in detection of M. jacuzzii using phenotypic and genotypic test of wrist synovial sample. Case presentation: A 73-year-old woman complained of pain and swelling in the right wrist for 4 months. Her body temperature was 37–38 °C, and symptoms, such as pain, swelling, and some movement limitation, were reported. Clinical laboratory parameters showed an elevated C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), and white blood cells (WBC) count. The sequences of hsp65, rpoB, 16S rDNA, and sodA genes indicated very high homology to M. jacuzzii. Conclusion: We report a case of synovial infection caused by M. jacuzzii in a patient with severe wrist pain in Iran, who was treated with amikacin, levofloxacin, and ethambutol. The outcomes of treatment after 8 months were positive, and no recurrence of infection was reported in the patient. Keywords: Mycobacterium jacuzzii, Synovial infection, Iran
Background In the past several years, the outbreak of human diseases associated with nontuberculous mycobacteria (NTM) has been increasing. The cause of this increase is probably multifactorial, depending on the host, nature of infectious agent, and their interactions [1]. Due to the redundancy of tissue and synovial fluid and a higher probability of penetrating injury, NTM tenosynovitis happens most frequently in the hand and wrist. Usually, slowly growing mycobacteria species, especially Mycobacterium (M.) marinum, are involved [2]. In the present study, we report for the first time the isolation of M. jacuzzii from wrist synovial in a 73-year-old woman patient.
* Correspondence: [email protected] 1 Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran 2 Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
Case presentation A 73-year-old woman complained of pain and swelling in the right wrist for 4 months. Her body temperature was 37–38 °C, and symptoms, such as pain, swelling, and some movement limitation, were reported. Moreover, clinical laboratory parameters showed an elevated C-reactive protein (CRP) level (24 mg/L), erythrocyte sedimentation rate (ESR) (51 mm/h), and white blood cells (WBC) count (121,000 cells per cubic millimeter). Also, the rheumatoid factor and antinuclear antibody were negative. No history of trauma, diabetes, or immunosuppressive drug consumption was reported. Meanwhile, the patient received a local injection of methylprednisolone (20 mg daily/2 weeks). His swollen partially resolved but worsened again. The synovial fluid sample was aspirated from the wrist and sent to Pasteur Institute of Iran in January 2019 for evaluating the pre
Data Loading...
