Prosthesis infection by Mycobacterium tuberculosis in a patient with rheumatoid arthritis: A case report and literature review.

347 20 mg/dl, protein of 111 mg/dl, WBC 14 mm 3 , neutrophils 16%, lymphocytes 84 found %, gram stain + + + yeast and bacterial antigens, with encapsulated blastoconidias found after staining with China ink, compatible with Criyptococcus sp. Methotrex-ate and prednisone were discontinued or decreased. We started treatment with amphotericin B, in increasing doses up to 1 g intravenously, with an adequate clinical response and infection control. Due to the presence of de novo diabetes mellitus, treatment with insulin was started based on a recommendation of endocrinology. Opportunistic CNS infections reported in patients with RA include progressive multifocal encephalopathy, aspergilloma, tuberculosis, infection with West Nile virus, bacterial meningitis, infection with rodococcus and cryptococcal meningitis; however, the patients who have been reported with these types of infection were undergoing biological therapy. 3–5 Cryptococcal infections reported in RA patients are summarized in Table 1. 6,8,9 When evaluating Table 1, it can be seen that most Cryptococcal infections in patients with RA present in the lungs, 10 followed by skin and meninges; one case showed spreading with multiorgan involvement and deadly consequences. The average age of presentation for any cryptococcal infection is 63.8 years (range: 47–82 years); the most frequently associated drugs are methotrexate and prednisone in 75% of cases. 66% of the patients who developed infections due to this microorganism were on biological therapy. Of the 3 patients who presented cryptococcal meningitis, only the patient reported in this case was not undergoing biological therapy. In conclusion, we report a case of cryptococcal meningitis in a patient with RA in non-biological antirheumatic treatment (gluco-corticoids and methotrexate). tuberculosis in a patient with rheumatoid arthritis previously exposed to ineffective etanercept therapy and revealed by infliximab. and Guillain-Barrè syndrome in a patient with rheumatoid arthritis receiving adalimumab therapy.cal meningitis in a patient treated with infliximab. meningitis in an HIV-negative patient with rheumatoid arthritis treated with rituximab. Lee FY, et al. Disseminated cryptococcosis initially presenting as cellulitis in a rheumatoid arthritis patient. Infección protésica por Mycobacterium tuberculosis en paciente con artritis reumatoide: reporte de un caso y revisión bibliográfica To the editor: Prosthetic knee infection by Mycobacterium tuberculosis (MT) is rare. 1,2 Reviews in 2011 and 2013 found 7 and 15 cases of pros-thetic infections due to MT, respectively. 3–5 Since the introduction of biological treatment for rheumatoid arthritis (RA), there has been an increase in the incidence of infection by MT, mainly in patients …