Journal Article

Arthritis Due to <i>Mycobacterium xenopi:</i> A Retrospective Study of 7 Cases in France

Carine Salliot, Nicole Desplaces, Philippe Boisrenoult, Anne Claude Koeger, Philippe Beaufils, Véronique Vincent, Patrick Mamoudy and Jean-Marc Ziza

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 43, issue 8, pages 987-993
Published in print October 2006 | ISSN: 1058-4838
Published online October 2006 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/507631
Arthritis Due to Mycobacterium xenopi: A Retrospective Study of 7 Cases in France

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Background. Mycobacterium xenopi is a nontuberculous mycobacterium responsible for opportunistic and nosocomial infections, chiefly of the lung; few cases of bone and joint infection have been reported. From July 1989 through May 1993, an outbreak of 58 cases of nosocomial discitis due to M. xenopi infection following percutaneous nucleotomy occurred in a French hospital. Peripheral M. xenopi arthritis seems exceedingly rare. We conducted a study to assess the epidemiological and clinical patterns of M. xenopi arthritis.

Methods. We retrospectively reviewed cases of M. xenopi arthritis reported from May 1993 through October 2004.

Results. We identified 7 cases, all of which occurred after invasive surgical procedures were performed on the affected joint, suggesting a nosocomial pattern of infection. Two patients may have been contaminated at the hospital where the M. xenopi discitis outbreak occurred. No source was identified in the other 5 patients. Despite the probable nosocomial nature of the infections, the diagnosis was delayed (mean time until diagnosis, 50 months). Repeated collection of deep tissue specimens for bacteriological analysis seemed crucial to the diagnosis. The treatment relied on combination antimicrobial therapy and surgery. Among 11 cases of M. xenopi osteoarticular infection reported in the literature from 1975 to 2005, (arthritis in 9 cases and osteitis in 2), none were nosocomial.

Conclusion. A high index of suspicion should be maintained to ensure the diagnosis of M. xenopi arthritis before chronic monoarthritis and before the development of irreversible joint damage.

Journal Article.  3147 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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