Volume 25, Number 6—June 2019
CME ACTIVITY - Synopsis
Nontuberculous Mycobacterial Musculoskeletal Infection Cases from a Tertiary Referral Center, Colorado, USA
Table 1
Patient no. | Age, y/sex | Immunocompromising conditions | Inciting or predisposing factor(s) | Time to symptom onset, mo | Reason care sought | Time from symptom onset to diagnosis, mo | Diagnostic procedure, source of microbiologic diagnosis |
---|---|---|---|---|---|---|---|
1 | 55/M | History of lymphoma, pseudogout, oral steroid use | Steroid injection, left ankle | UNK | Osteomyelitis, septic arthritis | 12 | Tissue sample from ankle debridement |
2 | 53/F | None | Pedicure | 0 | Synovitis, osteomyelitis, cellulitis | 4 | UNK; diagnosis at another hospital |
3 | 48/F | None | Second THA | UNK | PJI | UNK | Thigh fluid sampled during I&D |
4 | 45/M | None | AKA | 1 | Draining wound at stump | 2 | Sample of fluid draining from AKA stump |
5 | 64/F | None | Carpal tunnel release | 0 | Tenosynovitis, septic arthritis | 8 | Synovial fluid obtained during excision of synovitis |
6 | 69/F | Diabetes mellitus | THA | 6 | PJI | 9 | Synovial biopsy obtained during explantation |
7 | 23/F | Systemic lupus erythematosus, oral steroids, hydroxyl-chloroquine, mycophenolate mofetil | Avascular necrosis, ankle fusion | 3 | Septic arthritis, osteomyelitis, skin abscesses | 1 | UNK; diagnosis at another hospital |
8 | 57/F | Polymyositis, oral steroids, azathioprine, rituximab, methotrexate | ACL repair, arthroscopy, steroid injection | UNK | Septic arthritis | UNK | Aspirate of left knee and right hip |
9 | 76/M | Nonspecific autoimmune disease, oral steroids | Calcium pyrophosphate deposition disease, TKA | 0 | PJI | 2 | UNK; diagnosis at another hospital |
10 | 58/M | None | Trauma, steroid injection | 12 | Septic arthritis | 19 | UNK; diagnosis at another hospital |
11 | 77/F | Rheumatoid arthritis, prednisone, azathioprine | TKA | 300 | PJI | 12 | Synovial biopsy obtained during placement of antimicrobial spacer |
12 | 83/M | Malnutrition, prednisone | TKA | 168 | PJI | 8 | Tissue obtained during TKA revision |
13 | 49/F | None | TKA (revision) | 14 | PJI | 2 | UNK; diagnosis at another hospital |
14 | 24/F | Crohn’s disease, infliximab | Failed IV | 0 | Cellulitis, abscess | 7 | Skin biopsy |
*AKA, above-knee amputation; I&D, irrigation and debridement; PJI, prosthetic joint infection, THA, total hip arthroplasty; TKA, total knee arthroplasty; UNK, unknown.
1These first authors contributed equally to this article.
Page created: May 24, 2019
Page updated: May 24, 2019
Page reviewed: May 24, 2019
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