Mycobacterium avium-intracellulare cellulitis occurring with septic arthritis after joint injection: a case report

BACKGROUND: Cellulitis caused by Mycobacterium avium-intracellulare has rarely been described. Mycobacterium avium-intracellulare is a rare cause of septic arthritis after intra-articular injection, though the causative role of injection is difficult to ascertain in such cases. CASE PRESENTATION: A 57-year-old with rheumatoid arthritis treated with prednisone and azathioprine developed bilateral painful degenerative shoulder arthritis. After corticosteroid injections into both acromioclavicular joints, he developed bilateral cellulitis centered over the injection sites. Skin biopsy showed non-caseating granulomas, and culture grew Mycobacterium avium-intracellulare. Joint aspiration also revealed Mycobacterium avium-intracellulare infection. CONCLUSION: Although rare, skin and joint infections caused by Mycobacterium avium-intracellulare should be considered in any immunocompromised host, particularly after intra-articular injection. Stains for acid-fast bacilli may be negative in pathologic samples even in the presence of infection; cultures of tissue specimens should always be obtained

Suppurative parotitis Due to Candida glabrata: Case report and review of the literature

We report the case of an insulin-dependent diabetic woman with chronic renal insufficiency who developed Candida glabrata suppurative parotitis. Infectious inflammation of the parotid gland is typically bacterial in etiology, and candidal parotitis is a rarely documented finding with only 6 reported cases in the literature. Four cases involved Candida albicans; and 2, C. glabrata. Furthermore, our patient was uncharacteristically young and without ductal obstruction or other nidus for infection, which makes this case especially unique. We also present a literature review of the previous cases. © 2010 Lippincott Williams & Wilkins