Ye Jiaqing, Hao Jiahao, Zheng Cuiying, Song Minghui, Zhang Chenfeng, Gao Weili, Guo Yumei, Zhang Lijie
Department of Laboratory Medicine, Jiaxing Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Jiaxing, China.
Department of Laboratory Medicine, Hebei Medical University Third Hospital, Shijiazhuang, China.
Front Immunol. 2025 Aug 13;16:1618830. doi: 10.3389/fimmu.2025.1618830. eCollection 2025.
The complex (MABC), a multidrug-resistant environmental mycobacterium, rarely causes joint infections, which typically involve prosthetic joints. We describe the first case of native-knee infection linked to herbal steam therapy and osteoarthritis-a previously unreported scenario, accompanied by a literature review of 20 global MABC joint infection cases (2013-2024). Our findings present an alternative approach to the therapeutic guidelines for nontuberculous mycobacteria (NTM) infections, demonstrating successful clinical resolution in this single case using a short-course oral regimen.
A 54-year-old immunocompetent male with chronic knee osteoarthritis and a 6-year history of knee pain developed acute septic arthritis after knee-level high-temperature herbal steam baths. subsp was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and gene sequencing. Despite premature discontinuation of therapy, a 3-month oral regimen of clarithromycin (1,000 mg/day) combined with linezolid (600 mg/day) achieved full functional recovery, evidenced by a daily walking capacity of 8,000 steps.
Review of 20 MABC joint infection cases from the literature revealed the knee as the most frequently affected site (55%), with the majority of patients (95%) having a history of joint surgery. This case highlights: 1) Herbal steam therapy, degenerative joint disease, and prior interventions as underrecognized risk factors; 2) Rapid molecular diagnostics (MALDI-TOF MS/) critical for early diagnosis; 3) Short-course oral therapy (clarithromycin/linezolid) as a potential option for localized infection when prolonged therapy is impractical.
复合分枝杆菌(MABC)是一种耐多药的环境分枝杆菌,很少引起关节感染,这类感染通常累及人工关节。我们报告了首例与草药蒸汽疗法及骨关节炎相关的天然膝关节感染病例——这是一种此前未报道过的情况,并对20例全球MABC关节感染病例(2013 - 2024年)进行了文献综述。我们的研究结果为非结核分枝杆菌(NTM)感染的治疗指南提供了一种替代方法,在这例单一病例中使用短程口服方案实现了临床成功治愈。
一名54岁免疫功能正常的男性,患有慢性膝关节骨关节炎且有6年膝关节疼痛病史,在进行膝关节水平的高温草药蒸汽浴后发生急性化脓性关节炎。通过基质辅助激光解吸/电离飞行时间质谱(MALDI - TOF MS)和基因测序鉴定出了[具体菌种]亚种。尽管治疗提前中断,但为期3个月的口服克拉霉素(1000毫克/天)联合利奈唑胺(600毫克/天)方案使患者实现了完全功能恢复,每日行走能力达8000步即为证明。
对文献中20例MABC关节感染病例的综述显示,膝关节是最常受累的部位(55%),大多数患者(95%)有关节手术史。本病例突出了:1)草药蒸汽疗法、退行性关节疾病和既往干预作为未被充分认识的危险因素;2)快速分子诊断(MALDI - TOF MS/[具体方法])对早期诊断至关重要;3)当长期治疗不切实际时,短程口服疗法(克拉霉素/利奈唑胺)作为局部感染的一种潜在选择。