Periprosthetic joint infection due to Mycoplasma hominis in a multiple sclerosis patient treated with fingolimod

Eriko Muramatsu, Aki Sakurai, Yuka Kawabe, Yoshihiro Ritsuno, Toshiharu Sasaki, Yutaka Tsutsumi, Ryosuke Isobe, Rino Jinno, Tomihiko Ide, Yohei Doi

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)1672-1676
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume28
Issue number12
DOIs
Publication statusPublished - 12-2022

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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