Skin and joint infection by Mycobacterium chelonae: Rescue treatment with interferon gamma - 03/08/07
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Abstract |
Introduction |
Atypical mycobacteria are environmental organisms that cause opportunistic infections in humans.
Case report |
A 50-year-old electronics engineer sought advice about starting TNFα antagonist therapy for ankylosing spondylitis. Disease duration was 23years and current treatment was methylprednisolone 4mg/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 6months later prompted synovectomy of the knee followed by interferon gamma, 50μg/m2 body surface area subcutaneously 3 times a week. After 16months, there were no new skin or joint lesions, and the antimicrobials and interferon gamma were therefore discontinued.
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.
Le texte complet de cet article est disponible en PDF.Keywords : Mycobacterium chelonae, Ankylosing spondylitis, Septic arthritis, Interferon gamma
Plan
Vol 74 - N° 4
P. 385-388 - juillet 2007 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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