Infection of total hip prosthesis by Mycobacterium tuberculosis and Mycobacterium chelonae in a patient with rheumatoid arthritis

摘要: Atypical mycobacterial infections of the musculoskeletal system are very rare and generally associated with predisposing factors, such as trauma, use corticosteroids, or an immunocompromised state. There have only been three reports Mycobacterium chelonae prosthetic infection which two cases were total hip arthroplasty one knee no both tuberculosis M. occurring in same joint. We report a case patient rheumatoid arthritis treated low-dose methotrexate (15 mg/week) who developed after revision hip. Joint by mycobacteria clinically indistinguishable from those caused more common bacterial pathogens and, therefore, diagnosis is often delayed. Recurrent infections, particularly immunosuppressive patients, should alert physician to consider possibility tuberculous atypical infections. Obtaining appropriate cultures can be critical making directing treatment. With increasing agents, including TNF alpha inhibitors, it likely that there will increase number complicating arthroplasties.