Tenosynovitis caused by Mycobacterium malmoense in two kidney transplant recipients and review of the literature

Transpl Infect Dis. 2018 Feb;20(1). doi: 10.1111/tid.12810. Epub 2017 Dec 21.

Abstract

We report two unrelated cases of tenosynovitis caused by Mycobacterium malmoense in kidney transplant recipients. Both patients received immunosuppression and were referred to our tertiary hospital because of persisting complaints lasting >6 months not responding to corticosteroids or surgery. The mycobacterial cultures were positive for the slow-growing M. malmoense after several weeks of incubation. The patient in Case 1 was treated with a combination of surgical debridement and antibiotics, whereas the patient in Case 2 was only treated surgically. Both cases illustrate the doctor's delay in diagnosing mycobacterial infections, and remind us that nontuberculous mycobacterial infections should be part of the differential diagnosis of tenosynovitis, especially in immunocompromised patients.

Keywords: Mycobacterium malmoense; immunocompromised; mycobacterial infection; tenosynovitis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunocompromised Host
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Mycobacterium Infections, Nontuberculous / diagnosis
  • Mycobacterium Infections, Nontuberculous / drug therapy
  • Mycobacterium Infections, Nontuberculous / microbiology*
  • Nontuberculous Mycobacteria / drug effects
  • Nontuberculous Mycobacteria / isolation & purification
  • Tenosynovitis / diagnosis
  • Tenosynovitis / drug therapy
  • Tenosynovitis / microbiology*
  • Transplant Recipients

Substances

  • Anti-Bacterial Agents