结核性关节炎:新冠肺炎大流行期间被遗忘的诊断

T. Huwae, A. Pribadi
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引用次数: 0

摘要

结核病是一种主要影响肺部的呼吸系统疾病。挑战在于认识结核病的特征,包括肺外表现。结核性关节炎是肺外结核在关节的表现,它经常被忽视和误诊。一位41岁的女性患者以左手腕慢性疼痛三个月为主诉。病人有低烧,无呼吸道症状。局部检查显示肿胀、发热和压痛。红细胞沉降率(ESR)升高,胸片显示为肺结核。行关节切开术、清创及培养检查。我们开始辅助抗结核治疗。在评估中,她报告疼痛减轻,一般情况有所改善。结核性关节炎的独特之处在于其罕见的发病率和非特异性的临床表现。更好地理解这些问题将防止可能出现的诊断错误。及时治疗对于维持关节功能和防止永久性损伤至关重要。
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Tuberculous Arthritis: A Forgotten Diagnosis During Pandemic Covid-19
Tuberculosis (TB) is a respiratory disease that primarily affects the lungs. The challenge is to recognize the characteristic of TB disease, including extrapulmonary presentation. TB arthritis is an extrapulmonary TB presentation in the joint, which is frequently neglected and misdiagnosed. A 41-year-old female patient was presented with a major complaint of chronic pain in her left wrist for three months. The patient had a low-grade fever without respiratory symptoms. Local examination revealed swelling, warmth and tenderness. Erythrocyte sedimentation rate (ESR) was increased and chest radiograph demonstrated pulmonary TB. She underwent arthrotomy debridement and culture examination. We initiated adjuvant anti-tuberculous treatment. On the evaluation, she reported relief from pain and showed improvement in general condition. TB arthritis is unique due to its rare incidence and unspecific clinical manifestations. A better understanding of these issues will prevent possible diagnostic errors. Prompt treatment was crucial to maintain joint function and prevent permanent destruction.
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