Department of Internal Medicine, Las Palmas Del Sol Medical Center, El Paso, TX, USA.
Infect Disord Drug Targets. 2024;24(5):e170124225744. doi: 10.2174/0118715265274138231229070757.
The onset of prosthetic joint infections (PJIs) is characterized by early onset defined as within 90 days of the procedure, delayed onset defined as within 3 to 12 months, and late onset defined as over 12 months. In only a scant number of case reports, Mycobacterium flavescens associated infections are typically found in sputum cultures and associated with various forms of penetrating joint traumas, particularly post-surgical interventions. Due to its rarity in presentation among cases of PJIs, we have presented a case of PJI caused by .
We have, herein, reported a case of a 70-year-old male presenting with stabbing left knee pain over the past several months along with accompanying erythema and swelling with the presence of purulent discharge. Outpatient cultures have shown the growth of Mycobacterium flavescent; subsequently, the patient underwent a 2-stage revision arthroplasty and was treated with a three-drug regimen and implant 5 months later. Although being an atypical cause of PJIs, we emphasize the importance of considering NTM as a differential for immunocompromised patients, especially those with prior surgical intervention.
spp. related PJIs manifest clinical features similar to other bacteriacausing PJIs, such as warm, indurated edema at the surgical site resulting in wound dehiscence and joint effusion. Diagnosis of Mycobacterium spp. related PJIs includes history and physical examination findings, serum inflammatory markers, synovial fluid analysis, and culture. Concurrently with surgical interventions, utilization of antimicrobial agents provides additional control in Mycobacterium- related PJI. should be included among other NTMs as a possible cause of PJIs.
人工关节感染（PJI）的发病可分为早发性、迟发性和晚发性。早发性发病时间定义为术后 90 天内，迟发性为 3 至 12 个月，晚发性为 12 个月以上。在少数病例报告中，黄色分枝杆菌相关感染通常见于痰培养，并与各种形式的穿透性关节创伤有关，特别是手术后。由于其在 PJI 病例中的表现较为罕见，我们报告了一例由 引起的 PJI 病例。
我们报告了一例 70 岁男性病例，其过去几个月出现左膝关节刺痛，伴有红斑和肿胀，并有脓性分泌物。门诊培养显示黄色分枝杆菌生长；随后，患者接受了 2 期翻修关节成形术，并在 5 个月后接受了三联药物治疗和植入物治疗。虽然这是 PJI 的一种非典型病因，但我们强调应将 NTM 作为免疫功能低下患者的鉴别诊断，特别是那些有既往手术干预的患者。
分枝杆菌相关 PJI 的临床表现与其他细菌引起的 PJI 相似，如手术部位出现温暖、硬结性水肿，导致伤口裂开和关节积液。分枝杆菌相关 PJI 的诊断包括病史和体格检查、血清炎症标志物、滑液分析和培养。与手术干预同时，使用抗菌药物可提供分枝杆菌相关 PJI 的额外控制。应将 作为 PJI 的可能病因之一，与其他 NTM 一起列入考虑范围。
