Positive Culture of Atypical Mycobacterium Avium Following Revision Total Knee Arthroplasty.

We report a rare case of mycobacterial periprosthetic joint infection (PJI) after primary total knee arthroplasty 14 years earlier. Progressive knee pain over three years with a negative PJI infectious workup led to revision total knee arthroplasty. A surprising result was isolation of Mycobacterium avium from tissue cultures taken at time of revision surgery. After six months of antibiotic treatment, the patient is alive with well- functioning pain-free TKA at over one-year follow-up. Periprosthetic joint infection can present acutely or chronically years following total knee arthroplasty. Depending on the infecting organism, patients can present with sepsis, or a more indolent slower course that mimics aseptic loosening. In the absence of positive pre-operative labs and cultures, and based on the Musculoskeletal Infection Society (MSIS) criteria, aseptic loosening is a diagnosis of exclusion. An atypical infectious organism should be considered a possible cause and may require specialized cultures of operative specimens.

Citation

Jonathan Liu, Jacob Laperche, Marguerite Neill, Derek Jenkins. Positive Culture of Atypical Mycobacterium Avium Following Revision Total Knee Arthroplasty. Rhode Island medical journal (2013). 2024 May 02;107(5):7-10

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PMID: 38687260

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