title: [Unilateral sacroiliitis in multiorgan tuberculosis].
abstract: A tight but painless soft-tissue swelling in the left parasternal region, with chronic cough and lumbo-ischial pain becoming progressively more severe over several months, occurred in a 27-year-old man. The chest X-ray film was normal, radiography of the iliosacral joints revealed right-sided sacroiliitis. In the further course of the illness night sweat, nightly fever up to 38 degrees C and weight loss of 7 kg in two months, as well as severe treatment-resistant earache developed. When hospitalized, another chest X-ray film showed disseminated small nodular foci pointing to tuberculosis. Sputum and irrigation fluid from the right middle-ear contained Mycobacterium tuberculosis. Biopsy material from the parasternal tumour and middle-ear mucosa contained caseous granulomas, confirming the diagnosis of tuberculous sacroiliitis as part of multi-organ tuberculosis. Tuberculostatic treatment--400 mg isoniazid, 600 mg rifampicin, and 1,500 mg pyrazinamide daily (the latter discontinued after 8 weeks)--normalized the appearance in the chest X-ray film. The patient returned to his home in Holland and, four years later, reported that he was free of any symptoms, even during sport activity.
authors.affiliation: Medizinische Klinik, Kantonsspital Luzern.
authors.forename: F
authors.initials: F
authors.lastname: Gebel
authors.forename: H
authors.initials: H
authors.lastname: Gudat
authors.forename: K
authors.initials: K
authors.lastname: Wimpfheimer
authors.forename: U
authors.initials: U
authors.lastname: Schlumpf
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D008297:Male; D010033:Otitis Media / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D012446:Sacroiliac Joint; D014391:Tuberculosis, Miliary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D014399:Tuberculosis, Spinal / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents