© 2003 by BMJ Publishing Group Ltd & European League Against Rheumatism
LESSON OF THE MONTH
Mycobacterium malmoense infection of the knee
Rheumatology Department, Walsgrave Hospital, Clifford Bridge Road, Coventry CV2 2DX, UK
Correspondence to:
Correspondence to:
Dr R Callaghan;
robcallaghan@doctors.org.uk
Accepted 15 May 2003
Keywords: Mycobacterium malmoense; knee; infections
| The first 150 words of the full text of this article appear below. |
A 53 year old woman presented to the rheumatology department in November 1988 with polyarthralgia, Raynaud’s phenomenon, proximal weakness, and high creatine kinase. Muscle biopsy confirmed an inflammatory myopathy. Treatment was started with high dose corticosteroids and azathioprine. During the next 10 years her myositis was persistently active and her disease modifying treatment was changed to oral methotrexate, and then a combination of oral cyclosporin and intramuscular methotrexate. She continued receiving doses of prednisolone above 10 mg.
In May 1998 she developed a tense effusion of her right knee. Several synovial aspirates were negative for culture and crystals (mycobacterium was not tested for at this stage). Synovial microscopy showed ++ polymorphs (range 0 to +++, quantitative leucocyte counts were not performed) and no red blood cells. Her C reactive protein became raised at 39 mg/l and her blood neutrophil count was 18x109/l. Plain radiography showed mild degenerative
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This article has been cited by other articles:
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Haq, I, Isenberg, D, Callaghan, R
(2004). Mycobacterial knee infection in patients with idiopathic inflammatory myositis * Author's reply. Ann Rheum Dis
63: 611-611
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