J Rheum Dis.
2016 Feb;23(1):66-70. 10.4078/jrd.2016.23.1.66.
Nontuberculous Mycobacterium Arthritis and Spondylitis in a Patient with Lupus
- Affiliations
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- 1Division of Rheumatology, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. bettyboomboo@hanmail.net
- 2Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
- 3Division of Infection Disease, Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
- 4Department of Orthopedic Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
- KMID: 2222803
- DOI: http://doi.org/10.4078/jrd.2016.23.1.66
Abstract
- Approximately 90% of nontuberculous mycobacterium (NTM) infections involve the pulmonary system; NTM infections involving areas of the musculoskeletal system such as the joints or spine are uncommon. This report describes a case of refractory knee swelling in a patient with systemic lupus erythematosus (SLE). Indolent arthritis of the knee eventually progressed to spondylitis and a paraspinal abscess requiring surgical incision and drainage. The cause of the infectious arthritis and spondylitis was diagnosed as NTM infection, specifically Mycobacterium kansasii. This case emphasizes the importance of a high index of clinical suspicion for mycobacterial infection, as well as repeated attempts to isolate the organism, in patients with SLE who present with atypical chronic arthritis.
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