Department of Medicine, University of Pennsylvania, Philadelphia, 19104, USA.
Clin Exp Rheumatol. 2009 Sep-Oct;27(5):843-5.
Mycobacterium kansasii septic arthritis is rare, most often occurring in immunosuppressed patients including those with organ transplants. We present a case of oligoarticular M. kansasii infection in bilateral ankles, knee, and bilateral olecranon bursae in coexistence with tophaceous gouty arthropathy in a heart transplant patient. There are no reports of M. kansasii infection occurring in joints also affected by tophaceous gout. We contend that gouty arthropathy may alter the joint in such a way as to increase the risk of development of this infection in patients already at risk. In transplant patients presenting with a history and pattern of arthritis consistent with gout, a sufficient level of suspicion should be maintained for this infectious complication, even if monosodium urate crystals are seen on joint aspiration.
堪萨斯分枝杆菌性败血症性关节炎较为罕见，多发生于免疫抑制患者，包括器官移植患者。我们报告了一例心脏移植患者，其双侧踝关节、膝关节和双侧鹰嘴滑囊炎出现寡关节炎型堪萨斯分枝杆菌感染，同时并存痛风性关节炎性痛风石。目前尚无报告称关节同时受累的痛风石患者也会发生堪萨斯分枝杆菌感染。我们认为，痛风性关节炎可能会以某种方式改变关节，从而增加已经处于危险中的患者发生这种感染的风险。对于有符合痛风的关节炎病史和模式的移植患者，即使在关节抽吸时看到单钠尿酸盐晶体，也应保持对此感染性并发症的高度怀疑。
