[Isolated osseous tuberculosis : Differential diagnosis of treatment refractory osteomyelitis?]

Hendrik Schöllmann, M Glombitza, V Heck, M Dudda, E Steinhausen
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Abstract

We report the case of a 66-year-old female patient with a treatment refractory disorder of wound healing of the knee, who had already been treated several times surgically and with antibiotics for several months. The examination revealed a skin defect with a fistula in the region of the knee joint. The X‑ray imaging showed an extensive bony defect of unclear etiology. After specific diagnostics for acid-resistant rod-shaped bacteria, it was possible to identify Mycobacterium tuberculosis as the causative pathogen. After antitubercular drug treatment complete healing of the lesions was observed. The bony defect could be filled with bone substitute. There was neither a history of primary foci nor of a potentially infectious environment.

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孤立性骨结核:难治性骨髓炎的鉴别诊断?]
我们报告一例66岁的女性患者,膝部伤口愈合难治性疾病,已接受多次手术和抗生素治疗数月。检查发现膝关节区域有皮肤缺损及瘘管。X线影像显示广泛的骨缺损,病因不明。在对耐酸棒状细菌进行特异性诊断后,有可能确定结核分枝杆菌为致病病原体。经抗结核药物治疗后,病灶完全愈合。骨缺损可用骨替代物填充。既没有原发疫源地史,也没有潜在感染环境。
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