TY - JOUR
T1 - Periprosthetic joint infection due to Mycoplasma hominis in a multiple sclerosis patient treated with fingolimod
AU - Muramatsu, Eriko
AU - Sakurai, Aki
AU - Kawabe, Yuka
AU - Ritsuno, Yoshihiro
AU - Sasaki, Toshiharu
AU - Tsutsumi, Yutaka
AU - Isobe, Ryosuke
AU - Jinno, Rino
AU - Ide, Tomihiko
AU - Doi, Yohei
N1 - Publisher Copyright:
© 2022 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
PY - 2022/12
Y1 - 2022/12
N2 - Mycoplasma hominis is a commensal pathogen normally found in urogenital tract of humans and has been associated with a wide variety of extra-genitourinary infections, such as mediastinitis, bacteremia, and septic arthritis, particularly in immunocompromised patients. Here, we present a case of a 48-year-old male, who had been treated with fingolimod for relapsing multiple sclerosis and presented with fever and right-sided hip pain following total hip arthroplasty. CT scan revealed localized fluid collection in the right quadriceps femoris muscle adjacent to the joint cavity of right hip. The percutaneously aspirated fluid grew M. hominis, which was also isolated from blood culture. With diagnosis of periprosthetic joint infection, the patient underwent surgical debridement with retained prosthesis and was treated with antimicrobial agents. Infected granulation tissues excised from the hip was observed under an electron microscope, which revealed electron-dense rounded structures contained in neutrophils, consistent with Mycoplasma particles. Fingolimod, an immunomodulatory drug that acts on the sphingosine-1-phosphate receptor and prevents the egress of lymphocytes from lymph nodes, might increase host susceptibility to a systemic M. hominis infection.
AB - Mycoplasma hominis is a commensal pathogen normally found in urogenital tract of humans and has been associated with a wide variety of extra-genitourinary infections, such as mediastinitis, bacteremia, and septic arthritis, particularly in immunocompromised patients. Here, we present a case of a 48-year-old male, who had been treated with fingolimod for relapsing multiple sclerosis and presented with fever and right-sided hip pain following total hip arthroplasty. CT scan revealed localized fluid collection in the right quadriceps femoris muscle adjacent to the joint cavity of right hip. The percutaneously aspirated fluid grew M. hominis, which was also isolated from blood culture. With diagnosis of periprosthetic joint infection, the patient underwent surgical debridement with retained prosthesis and was treated with antimicrobial agents. Infected granulation tissues excised from the hip was observed under an electron microscope, which revealed electron-dense rounded structures contained in neutrophils, consistent with Mycoplasma particles. Fingolimod, an immunomodulatory drug that acts on the sphingosine-1-phosphate receptor and prevents the egress of lymphocytes from lymph nodes, might increase host susceptibility to a systemic M. hominis infection.
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U2 - 10.1016/j.jiac.2022.08.020
DO - 10.1016/j.jiac.2022.08.020
M3 - Article
C2 - 36064142
AN - SCOPUS:85137735518
SN - 1341-321X
VL - 28
SP - 1672
EP - 1676
JO - Journal of Infection and Chemotherapy
JF - Journal of Infection and Chemotherapy
IS - 12
ER -