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oai:figshare.com:article/33991984 2026-09-25T04:22:11Z category_393 portal_316 item_type_3 month_year_09_2026

Table 1_Case Report: Sequencing-supported probable osteoarticular Mycobacterium avium complex infection in rheumatoid arthritis.docx Jing Zhang (23775) Lina Zhang (112887) Sheng-Guang Li (323976) Ji Li (207201) Yadan Zou (14394791) Ting Long (5689913) Ruohan Yu (9300572) Yanfeng Zhang (145335) Foetal Development and Medicine hypogammaglobulinemia metagenomic next-generation sequencing Mycobacterium avium complex nontuberculous mycobacteria rheumatoid arthritis septic arthritis tenosynovitis Background<p>Osteoarticular Mycobacterium avium complex (MAC) infection is uncommon and can resemble inflammatory arthritis during immunosuppression.</p>Case description<p>A 52-year-old woman with an erosive seronegative rheumatoid arthritis phenotype and overlap autoimmune features developed progressive polyarticular swelling, wrist tenosynovitis, hip effusions, and low-back pain after cumulative immunosuppression. Investigations showed macrocytic anemia, lymphopenia, pan-hypogammaglobulinemia, marked B-cell depletion without anti-CD20 exposure, and cytomegalovirus DNAemia. Pre-treatment mNGS reported MAC-spectrum signals in hip, wrist, and elbow aspirates, including 355 right-hip reads. A separate pathogen-targeted joint-fluid sequencing report, with no anatomical site stated, detected MAC complex (116,330 normalized sequences; assay-estimated 10⁵ copies/mL). Neither result was interpreted as organism burden. No tissue histopathology, dedicated mycobacterial culture, or phenotypic susceptibility testing was performed. The working diagnosis was multisite sequencing-supported probable multifocal osteoarticular MAC infection without culture confirmation. Several interventions began concurrently. Selected follow-up MR images showed persistent destructive wrist disease and residual joint or periarticular fluid, but no standardized imaging or microbiological response endpoint was available.</p>Conclusion<p>In atypical arthritis progressing during immunosuppression, infection-focused sampling should precede further escalation. mNGS can provide an etiologic clue, but culture, histopathology, targeted testing, and longitudinal reassessment remain essential.</p> 2026-09-25T04:22:11Z Dataset Dataset 10.3389/fmed.2026.1954797.s002 https://figshare.com/articles/dataset/Table_1_Case_Report_Sequencing-supported_probable_osteoarticular_Mycobacterium_avium_complex_infection_in_rheumatoid_arthritis_docx/33991984 CC BY 4.0