Document Detail

Skin and joint infection by Mycobacterium chelonae: rescue treatment with interferon gamma.
MedLine Citation:
PMID:  17613267     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Atypical mycobacteria are environmental organisms that cause opportunistic infections in humans. CASE REPORT: A 50-year-old electronics engineer sought advice about starting TNFalpha antagonist therapy for ankylosing spondylitis. Disease duration was 23 years and current treatment was methylprednisolone 4 mg/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 6 months later prompted synovectomy of the knee followed by interferon gamma, 50 microg/m(2) body surface area subcutaneously 3 times a week. After 16 months, 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.
Sandrine Jousse-Joulin; Michel Garre; Xavier Guennoc; Claire Destombe; Isabelle Samjee; Valérie Devauchelle-Pensec; Alain Saraux
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2007-05-29
Journal Detail:
Title:  Joint, bone, spine : revue du rhumatisme     Volume:  74     ISSN:  1778-7254     ISO Abbreviation:  Joint Bone Spine     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-07-19     Completed Date:  2007-09-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  100938016     Medline TA:  Joint Bone Spine     Country:  France    
Other Details:
Languages:  eng     Pagination:  385-8     Citation Subset:  IM    
Rheumatology Department, Brest Teaching Hospital, Brest, France.
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MeSH Terms
Arthritis, Reactive / diagnosis,  drug therapy*,  surgery
Follow-Up Studies
Interferon-gamma / therapeutic use*
Knee Joint
Methylprednisolone / adverse effects,  therapeutic use
Middle Aged
Mycobacterium Infections, Atypical / diagnosis*,  drug therapy*
Mycobacterium chelonae / isolation & purification*
Orthopedic Procedures
Risk Assessment
Skin Diseases, Bacterial / diagnosis,  drug therapy*
Spondylitis, Ankylosing / diagnosis,  drug therapy
Treatment Failure
Reg. No./Substance:
82115-62-6/Interferon-gamma; 83-43-2/Methylprednisolone

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