TUBERCULOUS POLYARTHRITIS DUE TO MYCOBACT ERIUM-BOVIS

Infections due to Mycobacterium bovis have become uncommon. We report a case with polyarthritis and cutaneous nodules suggesting a rheumatic disease. This 61 year old male under corticosteroid therapy for asthm a developed febrile arthritis of the right wrist and cutaneous nodules that resolved rapidly under treatment with penicillin M and an aminog lycoside. Six months later, he developed arthritis of the right wrist and both elbows, as well as infection of a right hip prosthesis. The l eft wrist and left knee were then affected concomitantly. The cutaneou s nodules recurred. A giant cell granuloma without caseous necrosis wa s found upon examination of a biopsy specimen from a nodule. Granuloma tous lesions with caseous necrosis were seen in a specimen of synovial membrane from the right wrist. Antituberculous treatment ensured reso lution of the arthritides and nodules but failed to prevent loosening of the hip prosthesis. Acid-fast bacilli were found in the specimens t aken during removal of the prosthesis. After three months, cultures of synovial membrane specimens from the knee grew Mycobacterium bovis.