Ks. Kanik et Dp. Greenwald, Mycobacterium avium/Mycobacterium intracellulare complex-associated arthritis masquerading as a seronegative rheumatoid arthritis, JCR-J CLIN, 6(3), 2000, pp. 154-157
Mycobacterium avium/Mycobacterium intracellulare complex (MAC) is a rare ca
use of tenosynovitis. We describe a case in which a previously healthy pati
ent developed bilaterally symmetric synovitis and was treated with disease
modifying anti rheumatic drugs (DMARDs); the synovitis progressed into a bi
laterally symmetric chronic granulomatous tenosynovitis that was uncontroll
able despite a synovectomy and DMARD therapy. Three years after developing
symptoms, and 21/2 years after her diagnosis of rheumatoid arthritis, MAC w
as cultured from synovial fluid. All DMARDS were stopped, and the patient r
eceived a total of 24 months of triple antibiotic therapy. All swelling and
stiffness resolved after 7 months of therapy. The patient remains asymptom
atic two months after completion of antibiotic therapy. Rheumatologists and
other arthritis specialists need to include MAC in their differential diag
nosis of seronegative symmetrical inflammatory arthritis.