[Tuberculosis manifestations in the musculoskeletal system exemplified by Poncet's disease].
Tuberculosis is a communicable disease that is occasionally complicated by arthritis, either as part of a disseminated primary infection or through late reactivation, often in immunocompromised hosts such as elderly people, HIV-positive patients or patients under immunosuppressive therapy. Even though musculoskeletal manifestations occur in only about 2% of tuberculosis cases, they can be very heterogeneous and present as spondylitis, osteomyelitis or mono-oligo-polyarthritis. Because of the potential for disastrous outcomes in cases where the diagnosis is delayed, it is important to recognize the multiple rheumatological manifestations of tuberculosis. This case report on a patient with Poncet's disease discusses a current hypothesis regarding pathogenesis of reactive arthritis based on rheumatological manifestations of tuberculosis. The genomic detection of Mycobacterium tuberculosis, to differentiate between infectious arthritis and reactive arthritis by polymerase chain reaction, is of particular importance.
Kowalski
M
M
Klinik für Rheumatologie und klinische Immunologie/Allergologie, Universität Bern.
Seitz
M
M
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000503:physiopathology; D003937:Diagnosis, Differential; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014376:Tuberculosis / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*