Skin and joint infection by Mycobacterium chelonae: Rescue treatment with interferon gamma

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• 作者：S ; rine Jousse-Joulin ; Michel Garre ; Xavier Guennoc ; Claire Destombe ; Isabelle Samjee ; Valé ; rie Devauchelle-Pensec ; Alain Saraux
• 关键词：Mycobacterium chelonae ; Ankylosing spondylitis ; Septic arthritis ; Interferon gamma
• 刊名：Joint Bone Spine
• 出版年：2007
• 期刊代码：138_1297319x
• 类别：med
• 出版时间：July 2007
• 卷：74
• 期：4
• 页码：385-388
• 文件大小：249 K

摘要

Atypical mycobacteria are environmental organisms that cause opportunistic infections in humans.

class="h4">Case report

A 50-year-old electronics engineer sought advice about starting TNFα antagonist therapy for ankylosing spondylitis. Disease duration was 23 years and current treatment was methylprednisolone 4 mg/d. Atypical skin lesions and knee arthritis were noted. Fluid aspirated from the knee showed inflammatory properties and a few acid-fast bacteria, which a line probe assay identified as Mycobacterium chelonae. The same organism was found in a skin biopsy from a thigh lesion. Antimicrobial treatment was started immediately. Inadequate results 6 months later prompted synovectomy of the knee followed by interferon gamma, 50 ;c;g/m² body surface area subcutaneously 3 times a week. After 16 months, there were no new skin or joint lesions, and the antimicrobials and interferon gamma were therefore discontinued.

class="h4">Conclusion

This highly unusual case suggests that interferon gamma may be effective in patients with M. chelonae infection that fails to respond adequately to antimicrobials.