Cutaneous nontuberculous mycobacterial infection after intra-articular corticosteroid injection in a patient with psoriatic dactylitis

TL;DR

A patient with psoriatic dactylitis developed a rare skin infection after a corticosteroid injection, highlighting the risk in immunosuppressed individuals.

Contribution

This is the first reported case of nontuberculous mycobacterial superinfection in dactylitis following corticosteroid injection.

Findings

M. abscessus was identified in a patient with psoriatic dactylitis after corticosteroid injection.

The case highlights the risk of NTM infections in immunosuppressed patients receiving localized treatments.

Abstract

The incidence of skin nontuberculous mycobacterial (NTM) infections has been rising in recent years, paralleling the increase in invasive procedures and immunosuppression. We present a case involving a patient undergoing treatment with a tumor necrosis factor blocker (Etanercept®) for psoriatic dactylitis, who showed clinical deterioration 30 days following intra-articular corticosteroid therapy. Liquid culture media identified M. abscessus, prompting the initiation of combination antibiotic therapy. To the best of our knowledge, this is the first reported case of an NTM superinfection in dactylitis, underscoring the importance of screening for these infections in immunosuppressed patients receiving localized injectable treatments.

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