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Rommens OA, Kolkman WF, van Wijngaarden P. Mycobacterium wolinskyi infection after breast augmentation: A case report and comprehensive review. IJID REGIONS 2024; 11:100378. [PMID: 38947736 PMCID: PMC11214365 DOI: 10.1016/j.ijregi.2024.100378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/06/2024] [Indexed: 07/02/2024]
Abstract
We present a case report about a 26-year-old female with a Mycobacterium wolinskyi surgical site infection after bilateral breast augmentation. In a unique approach compared with previously reported cases, the patient was successfully treated in an outpatient setting using only orally administered cotrimoxazole (trimethoprim-sulfamethoxazole) and ciprofloxacin with one-sided preservation of the breast prothesis. We also provide a comprehensive overview of all report cases of M. wolinskyi infections available in the PubMed database until December 2023 and compare the different diagnostic and therapeutic approaches.
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Affiliation(s)
- Oscar A. Rommens
- Department of Internal Medicine, Amphia Hospital, Breda, Netherlands
- Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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Aier S, Kalra S, Varma M, Pandey V. Atypical mycobacterium infection following anterior cruciate ligament reconstruction. BMJ Case Rep 2023; 16:e253440. [PMID: 37802587 PMCID: PMC10565175 DOI: 10.1136/bcr-2022-253440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023] Open
Abstract
A man in his 20s presented with instability of the right knee following an incident of fall from a height. He was clinicoradiologically diagnosed to have an anterior cruciate ligament (ACL) tear for which he underwent ACL reconstruction. Postoperatively, he was started on an accelerated ACL rehabilitation protocol. Six weeks postoperatively, he developed features of subclinical septic arthritis for which he underwent arthroscopic debridement. Intraoperative samples cultured Mycobacterium abscessus complex on MGIT 960 system. The patient subsequently had to undergo another debridement after 1 month as there were clinical signs of persisting infection. The graft was intact even on the second debridement and after removing the implants. This case reports a rare complication of ACL reconstruction with infection by atypical mycobacterium and the clinical outcome. It also emphasises that prompt surgical intervention can save the graft.
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Affiliation(s)
- Sashitemjen Aier
- Orthopaedics, Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Saher Kalra
- Orthopaedics, Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Muralidhar Varma
- Infectious Diseases, Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Vivek Pandey
- Orthopaedics, Kasturba Medical College Manipal, Manipal, Karnataka, India
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Fix WC, Sheth NP, Braffman MN. Mycobacterium fortuitum Prosthetic Joint Infection After Total Hip Arthroplasty: A Case Report. JBJS Case Connect 2021; 10:e0343. [PMID: 32649134 DOI: 10.2106/jbjs.cc.18.00343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
CASE A 57-year-old man presented with a Mycobacterium fortuitum prosthetic joint infection (PJI) after right total hip arthroplasty refractory to the initial revision surgery and cement spacer placement. The patient was subsequently treated with 2-stage total joint arthroplasty revision surgery using an antibiotic-laden spacer customized to include meropenem and delayed reimplantation to allow for prolonged, systemic antimicrobial treatment with multiple antimicrobials, including levofloxacin and linezolid. CONCLUSIONS There is little evidence to guide practitioners in the diagnosis and treatment of PJI caused by rare, rapidly growing mycobacteria (RGM) such as M. fortuitum. This case demonstrates a successful strategy for the treatment of RGM PJI.
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Affiliation(s)
- William C Fix
- 1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania 2Department of Orthopaedic Surgery, Adult Hip and Knee Reconstruction, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 3Section of Infectious Diseases, Pennsylvania Hospital, Philadelphia, Pennsylvania
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Kitajima H, Oba Y, Ohira T, Asaoka T, Atsumi Y, Nakajima T, Okura T. First case report of prosthetic valve endocarditis caused by Mycobacterium wolinskyi. J Infect Chemother 2021; 27:766-769. [PMID: 33402304 DOI: 10.1016/j.jiac.2020.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/14/2020] [Accepted: 12/18/2020] [Indexed: 11/29/2022]
Abstract
To date, only 26 cases of Mycobacterium wolinskyi infections have been reported in humans. We herein report a first case of prosthetic valve endocarditis due to this organism after cardiovascular surgery. An 82-year-old man presented with repeat episodes of syncope and fever after aortic valve replacement, mitral valve replacement, left atrial appendage closure, and pulmonary vein isolation. Blood cultures maintained in aerobic bottles were repeatedly positive after 90-100 hours, and Gallium scan revealed abnormal accumulations in the sternum and left testis. While colonies formed by culturing the fluid of the parasternal area and blood cultures revealed gram-positive rods, we could not analyze the colony using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF). M. wolinskyi was finally identified on 16S rRNA, hsp65, and rpoB gene sequencing. We treated the patient with multiple antimycobacterial drugs, i.e., amikacin, imipenem, and clarithromycin for 6 weeks, which was changed to oral ciprofloxacin and minocycline for 12 months. This case highlights the need to consider rapidly growing mycobacteria, including M. wolinskyi, if chronic fever persists from weeks to months after surgery, the blood culture is positive, and the organism is not identified. In addition, sequencing the 16S rRNA, hsp65, and rpoB genes is essential for diagnosis.
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Affiliation(s)
- Heita Kitajima
- Department of General Medicine, Osaka General Medical Center, 3-1-56, Sumiyoshi Bandaihigashi, Osaka, 558-8558, Japan.
| | - Yuichiro Oba
- Department of General Medicine, Osaka General Medical Center, 3-1-56, Sumiyoshi Bandaihigashi, Osaka, 558-8558, Japan
| | - Takahisa Ohira
- Department of General Medicine, Osaka General Medical Center, 3-1-56, Sumiyoshi Bandaihigashi, Osaka, 558-8558, Japan
| | - Tomohiro Asaoka
- Department of General Medicine, Osaka General Medical Center, 3-1-56, Sumiyoshi Bandaihigashi, Osaka, 558-8558, Japan
| | - Yoshihiro Atsumi
- Department of General Medicine, Osaka General Medical Center, 3-1-56, Sumiyoshi Bandaihigashi, Osaka, 558-8558, Japan
| | - Takahiro Nakajima
- Department of General Medicine, Osaka General Medical Center, 3-1-56, Sumiyoshi Bandaihigashi, Osaka, 558-8558, Japan
| | - Takayuki Okura
- Department of General Medicine, Osaka General Medical Center, 3-1-56, Sumiyoshi Bandaihigashi, Osaka, 558-8558, Japan
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Bhatnagar N, Poojary A, Maniar A, Contractor A, Rohra S, Kumar G. Mycobacterium wolinskyi: A Rare Strain Isolated in a Persistent Prosthetic Knee Joint Infection: A Case Report. JBJS Case Connect 2019; 9:e0315. [PMID: 31373914 DOI: 10.2106/jbjs.cc.18.00315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
CASE A patient who underwent first-stage revision procedure elsewhere for prosthetic joint infection (PJI) of the knee with Kocuria rosea presented to us 9 months after the index surgery, with persistent infection. First-stage revision surgery was repeated and Mycobacterium wolinskyi, a rare rapidly growing nontuberculous mycobacterium (RGM), was isolated from samples obtained by sonication of the cement spacer. After a prolonged antibiotic course, definitive implantation surgery was done. One-year postimplantation, patient remains infection free. CONCLUSIONS This is only the second known case of knee PJI caused by M. wolinskyi. This case highlights the possibility of RGM getting masked by other organisms.
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Affiliation(s)
- Nishit Bhatnagar
- Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India
| | - Aruna Poojary
- Department of Pathology and Microbiology, Breach Candy Hospital, Mumbai, India
| | - Adit Maniar
- Lilavati Hospital & Research Centre and Breach Candy Hospital, Mumbai, India
| | | | - Seema Rohra
- Department of Pathology and Microbiology, Breach Candy Hospital, Mumbai, India
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Vutescu ES, Koenig KM. Mycobacterium cosmeticum Infection After Total Knee Arthroplasty: A Case Report. JBJS Case Connect 2017; 7:e3. [PMID: 29244685 DOI: 10.2106/jbjs.cc.16.00099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
CASE A 67-year-old immunocompetent man presented with a periprosthetic infection 4 months after a left total knee arthroplasty. Repeated aspirations failed to show any organism growth. After irrigation and debridement with polyethylene exchange, there was minimal clinical improvement. Subsequently, the patient developed an arthrocutaneous fistula, which prompted a 2-stage revision arthroplasty. Mycobacterium cosmeticum grew on the culture specimens taken during this procedure, and the patient was treated with 6 months of antibiotics. CONCLUSION To our knowledge, this is the first reported case of an M. cosmeticum prosthesis-related infection. The patient recovered well following a 2-stage revision arthroplasty and treatment with a Mycobacterium species-specific antibiotic.
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Affiliation(s)
| | - Karl M Koenig
- Department of Orthopaedics and Sports Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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Abstract
Infected total knee arthroplasty (TKA) due to Mycobacterium abscessus is very rare with only three such cases described in literature. Only one case was managed successfully, however, with a prolonged course of anti tubercular therapy. In this case report, we present an elderly lady with infected TKA after 2 years of the primary procedure. Although initially it grew different bacteriae, M. abscessus was isolated during the second debridement. She was successfully treated with total of 5 months of second line anti tubercular drugs with revision prosthesis performed during chemotherapy. Two years followup revealed satisfactory outcome with no relapse.
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Affiliation(s)
- Priyadarshi Amit
- Department of Orthopaedics and Joint Replacement, Max Institute of Musculoskeletal Sciences, Saket, New Delhi, India,Address for correspondence: Dr. Priyadarshi Amit, 481, NK-1, Indirapuram, Ghaziabad - 201 010, Uttar Pradesh, India. E-mail:
| | - Sumeet Rastogi
- Department of Orthopaedics and Joint Replacement, Max Institute of Musculoskeletal Sciences, Saket, New Delhi, India
| | - SKS Marya
- Department of Orthopaedics and Joint Replacement, Max Institute of Musculoskeletal Sciences, Saket, New Delhi, India
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Draft Genome Sequence of Mycobacterium wolinskyi, a Rapid-Growing Species of Nontuberculous Mycobacteria. GENOME ANNOUNCEMENTS 2016; 4:4/2/e00138-16. [PMID: 26988052 PMCID: PMC4796131 DOI: 10.1128/genomea.00138-16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Mycobacterium wolinskyi is a nonpigmented, rapidly growing nontuberculous mycobacterium species that is associated with bacteremia, peritonitis, infections associated with implants/prostheses, and skin and soft tissue infections often following surgical procedures in humans. Here, we report the first functionally annotated draft genome sequence of M. wolinskyi CDC_01.
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Ng SWL, Yee Han DL. Lessons learnt from an atypical mycobacterium infection post-anterior cruciate ligament reconstruction. Clin Orthop Surg 2015; 7:135-9. [PMID: 25729530 PMCID: PMC4329526 DOI: 10.4055/cios.2015.7.1.135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Accepted: 02/25/2014] [Indexed: 12/02/2022] Open
Abstract
Infections following anterior cruciate ligament reconstruction are rare, with no previous reports citing Mycobacterium abscessus as the culprit pathogen. A 22-year-old man presented twice over three years with a painful discharging sinus over his right tibia tunnel site necessitating repeated arthroscopy and washout, months of antibiotic therapy, and ultimately culminating in the removal of the implants. In both instances, M. abscessus was present in the wound cultures, along with a coinfection of Staphyloccocus aureus during the second presentation. Though rare, M. abscessus is an important pathogen to consider in postoperative wounds presenting with chronic discharging sinuses, even in healthy non-immunocompromised patients. This case illustrates how the organism can cause an indolent infection, and how the removal of implants can be necessary to prevent the persistence of infection. Coinfection with a second organism is not uncommon and necessitates a timely change in treatment regime as well.
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Affiliation(s)
- Stacy W L Ng
- Department of Orthopedic Surgery, Changi General Hospital, Singapore
| | - Dave Lee Yee Han
- Department of Orthopedic Surgery, Changi General Hospital, Singapore
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