rifampin and Soft-Tissue-Neoplasms

Mycobacterium kansasii is one of the major non-tuberculous mycobacteria species that typically cause pulmonary diseases. M. kansasii is known to cause septic arthritis as an extrapulmonary disease in immunosuppressed patients or chronic skin disease. Herein, we present a case of M. kansasii arthritis involving the elbow of an immunocompetent patient, which was initially suspected to be a soft-tissue tumor. A 70-year-old man presented with a swollen left elbow that had progressed for 18 months with deteriorating arthralgia and limited range of motion. Magnetic resonance imaging revealed filling of the intra-articular space of the elbow and surrounding of the radial head with a soft tissue mass with mixed signal intensity. Initial incisional biopsy was performed via the lateral approach to the elbow joint, and pathological examination of the mass did not reveal any evidence of malignancy. One year after the first operation, arthroscopic surgery was performed to excise the mass following the recurrence of swelling and limited function of the elbow. Pathological examination of the resected synovium revealed epithelioid granulomas containing a multinucleated giant cell and inflammatory cell infiltration, characteristic of mycobacterial infection. M. kansasii was cultured after 2 weeks of incubation of the synovial sample. He experienced full resolution of the swelling and limited function following a combination of synovectomy and multidrug antimycobacterial treatment (rifampin 600 mg/day, clarithromycin 800 mg/day, and ethambutol 750 mg/day). This case highlights the need to consider this rare infection in the differential diagnosis of intra-articular soft tissue tumor-like lesions even in immunocompetent patients.

Topics: Aged; Anti-Bacterial Agents; Arthritis, Infectious; Clarithromycin; Diagnosis, Differential; Elbow Joint; Ethambutol; Humans; Immunocompetence; Magnetic Resonance Imaging; Male; Mycobacterium Infections, Nontuberculous; Mycobacterium kansasii; Rifampin; Soft Tissue Neoplasms; Treatment Outcome

Sparganosis is a rare parasitic infection caused by the plerocercoid tapeworm larva of the genus Spirometra.. We report the case of a 67-year-old man with a mass over the anteromedial surface of the proximal extremity of the tibia. We surgically excised a bursa containing Spirometra larvae.. Sparganosis is a rare parasitic infection. We found no cases of lower extremity sparganosis combined with bursitis reported in the literature.. Sparganosis should be considered in the differential diagnosis of soft tissue tumors, especially among patients who frequently have consumed mountain water or raw snakes or frogs.

Topics: Aged; Animals; Antitubercular Agents; Bursa, Synovial; Diagnosis, Differential; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Male; Rifampin; Soft Tissue Neoplasms; Sparganosis; Sparganum; Tibia; Treatment Outcome

We report here a 70-year-old female patient who was diagnosed with brucellosis and presented with mass formation resembling a tumor. The mass was protuberant, 10 cm from the skin surface with a diameter of 15 cm, located at the inferior-lateral region of the left scapula. Brucella melitensis was yielded from culture of mass fluid. The patient responded to ceftriaxone, rifampin and doxycycline therapy and recovered without any sequela at the end of surgery and 3 months of medical treatment.

Topics: Aged; Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Ceftriaxone; Diagnosis, Differential; Doxycycline; Drug Therapy, Combination; Female; Humans; Rifampin; Scapula; Soft Tissue Neoplasms