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Mycobacterium wolinskyi: A Rare Strain Isolated in a Persistent Prosthetic Knee Joint Infection

A Case Report

Bhatnagar, Nishit MS Ortho, DNB Ortho, MRCS1; Poojary, Aruna MD, DNB, D (ABMM), Dip HIC, CIC2; Maniar, Adit MBBS, MS Ortho3; Contractor, Armaity MD4; Rohra, Seema MD5; Kumar, Gaurav MS Ortho, Mch Ortho6

doi: 10.2106/JBJS.CC.18.00315
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Case: A patient who underwent first-stage revision procedure elsewhere for prosthetic joint infection (PJI) of the knee with Kocuria rosea presented to us 9 months after the index surgery, with persistent infection. First-stage revision surgery was repeated and Mycobacterium wolinskyi, a rare rapidly growing nontuberculous mycobacterium (RGM), was isolated from samples obtained by sonication of the cement spacer. After a prolonged antibiotic course, definitive implantation surgery was done. One-year postimplantation, patient remains infection free.

Conclusions: This is only the second known case of knee PJI caused by M. wolinskyi. This case highlights the possibility of RGM getting masked by other organisms.

1Department of Orthopaedics, Indraprastha Apollo Hospital, New Delhi, India

2Department of Pathology and Microbiology, Breach Candy Hospital, Mumbai, India

3Lilavati Hospital & Research Centre and Breach Candy Hospital, Mumbai, India

4Breach Candy Hospital, Mumbai, India

5Department of Pathology and Microbiology, Breach Candy Hospital, Mumbai, India

6Jhansi Orthopaedic Hospital, Jhansi, India

E-mail address for N. Bhatnagar: nishitbhatnagar@yahoo.co.in

Investigation performed at the Department of Orthopaedics, Breach Candy Hospital, Mumbai, India

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSCC/A839).

Copyright © 2019 by The Journal of Bone and Joint Surgery, Incorporated
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