How would you manage an elderly patient with a periprosthetic knee infection secondary to mycobacterium chelonae who is a poor surgical candidate for removal of hardware?

Not a lot of data to guide this, but for nontuberculous mycobacterial (NTM) prosthetic joint infections (PJIs), I would ensure the surgeons do a thorough incision and drainage (I&D) and washout, even if they cannot remove the hardware, followed by an intensive regimen of 3 to 4 active antimycobacter...

The answer has to be nuanced. How was the culture obtained? Just an aspiration, or was it from an open debridement procedure? How well was that procedure tolerated? Was this a DAIR procedure? Is there a sinus tract? Are there systemic symptoms? Any other pathogens in culture?

You can try treating th...