nontuberculous mycobacterial arthritis

Introduction

Introduction to nontuberculous mycobacterial arthritis Mycobacteria are one of the major pathogens of chronic bone and joint infection. Non-tuberculous mycobacteria, mostly mycobacteria in avian cells, Mycobacterium marinum, Mycobacterium rabbits, Mycobacterium kansii, etc., which are present in soil and water. It is not yet confirmed that humans spread infections between each other. Clinical manifestations and X-ray features are slow to progress, sometimes remain static, and sometimes lurk for many years. Due to the lack of signs, it takes an average of 19 months from symptom onset to diagnosis. basic knowledge The proportion of illness: 0.008% - 0.015% Susceptible people: no special people Mode of infection: non-infectious Complications: osteomyelitis synovitis tenosynovitis

Cause

Nontuberculous mycobacterial arthritis etiology

Cause:

Atypical mycobacteria are often found in soil and water and have not been shown to be transmitted between humans. They produce pathological changes similar to those of Mycobacterium tuberculosis, so careful analysis of their growth characteristics, biological and serological characteristics, birds Mycobacterium avium intraccllulare (MAI), Mycobacterium kansii; Mycobacterium marinum, Mycobacterium fortuitum and Mycobacterium fortuit can invade bones and joints, and they spread throughout the body like M. tuberculosis. Skeletal lesions are often single, and multiple and multiple osteomyelitis are more common.

Pathogenesis

Non-tuberculous mycobacteria, mostly mycobacteria in avian cells, Mycobacterium marinum, Mycobacterium rabbits, Mycobacterium kansii, etc., which are present in soil and water, and it is not yet confirmed that humans spread to each other. Infected, non-tuberculous mycobacteria produce pathological changes in the human body, which is very similar to the pathological changes caused by Mycobacterium tuberculosis. It rarely causes systemic dissemination like Mycobacterium tuberculosis, and the affected joints are often single joints.

Prevention

Nontuberculous mycobacterial arthritis prevention

1. The law of life, pay attention to nutrition, exercise to enhance their immune function.

2. Pay attention to the environment and personal hygiene, often take a bath and change clothes.

3. Do a good job in labor protection.

Complication

Nontuberculous mycobacterial arthritis complications Complications osteomyelitis synovitis tenosynovitis

Can be complicated by fasciitis and tenosynovitis, osteomyelitis, synovitis and soft tissue infection.

Symptom

Non-tuberculous mycobacterial arthritis symptoms common symptoms skeletal mass joint swelling soft tissue infection

After non-tuberculous mycobacteria infect the human body, it will not cause acute onset, no acute clinical symptoms, and the process of purulent often develops unconsciously, sometimes the diagnosis can be delayed for 3 to 5 years.

1. Mycobacterium avium intracellulare (MAI) spreads only after invading bones and joints, and is easily relapsed after treatment. Mycobacterium kansos, in addition to clinical manifestations of lung lesions, can also There are extensive bone and joint and periarticular lesions, common carpal tunnel syndrome, arthritis, osteomyelitis, fasciitis, tenosynovitis, Mycobacterium marinum live in fish and water, infected parts are more common in the hands and knee joints, showing joints Synovitis can also involve tendons, ligaments and bones, complexes of mycobacteria and rabbit mycobacteria, which can cause synovitis, soft tissue infections and bone infections.

2. The clinical manifestations of Mycobacterium Kansas are chronic lung lesions. There are also extensive bone, joint and joint lesions, common carpal tunnel syndrome, arthritis, osteomyelitis, fasciitis and tenosynovitis. Recurrence after replacement.

3. Mycobacterium marinum is living in water and fish. The infection is related to occupation and personal well-being. The infected parts are more common in the skin, muscles and skeletal system, especially in the hands and knees. The clinical manifestations are synovitis and tendon. , ligaments and bones can also be involved.

4. The complex of mycobacterium and rabbit mycobacteria can cause osteomyelitis, synovitis and soft tissue infection. It must be emphasized that clinical inactivity and the quiescence of the disease do not mean that the infection has been cured, and follow-up and supervision are needed.

According to clinical manifestations and characteristics, combined with characteristic signs can be diagnosed.

Examine

Nontuberculous mycobacterial arthritis examination

Mycobacterium bacilli can be found in acid bacilli in abscesses and necrotic tissues. The epidermal layer of Mycobacterium kansii is thickened, keratinous hyperplasia with parakeratosis, chronic granulomatous inflammation in the dermis, mononuclear or multinucleated giant cells, with small abscess or necrosis.

Diagnosis

Diagnosis and identification of nontuberculous mycobacterial arthritis

Note the differentiation from other infectious arthritis.

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