Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges.

IF 1.1 Q4 INFECTIOUS DISEASES IDCases Pub Date : 2024-12-17 eCollection Date: 2025-01-01 DOI:10.1016/j.idcr.2024.e02134
Asbah Rahman, Aastha Randhawa, Yu Shia Lin
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Abstract

An 85-year-old woman with a history of total knee replacements for osteoarthritis in the past, presented with left knee swelling and pain that persisted for 14 months. An initial diagnosis of synovial cyst was made, and she underwent multiple aspirations and symptomatic treatments without improvement. Repeat arthrocentesis showed a WBC of 56,000/μL with 61 % neutrophils and 34 % lymphocytes. Synovial fluid bacterial and fungal cultures were negative. The acid-fast bacilli (AFB) culture revealed the Mycobacterium tuberculosis complex and was confirmed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) Mass Spectrometry. This case highlights the challenges of diagnosing tuberculous prosthetic joint infection in an elderly individual with knee pain.

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揭露结核性关节炎在假体关节:诊断和治疗的挑战。
85岁女性,既往因骨关节炎行全膝关节置换术,左膝肿胀疼痛持续14个月。初步诊断为滑膜囊肿,她接受了多次检查和对症治疗,但没有好转。重复关节穿刺显示WBC为56000 /μL,中性粒细胞占61% %,淋巴细胞占34% %。滑液细菌和真菌培养均为阴性。抗酸杆菌(AFB)培养显示结核分枝杆菌复合体,并通过基质辅助激光解吸/电离飞行时间(MALDI-TOF)质谱法证实。本病例强调了诊断膝关节疼痛的老年人结核性假体关节感染的挑战。
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来源期刊
IDCases
IDCases INFECTIOUS DISEASES-
CiteScore
2.60
自引率
6.70%
发文量
300
审稿时长
10 weeks
期刊最新文献
Scrub typhus associated with reactive arthritis: A case report and literature review. A case of disseminated blastomycosis in New England. Fever for days: A challenging case of dalbavancin-induced fever. Severe dual fungal infection after bispecific antibody therapy: A case of invasive aspergillosis and mucormycosis in immunocompromised patient. Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges.
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