Pulmonary tuberculosis with delayed tuberculosis infection of total knee arthroplasty.
Tuberculous prosthetic joint infection is rare. While early diagnosis is critical for treatment, it is usually delayed. Here, we present the case of a 72-year-old patient who underwent total knee arthroplasty for his right knee due to degenerative arthritis 4 years ago. Three years after arthroplasty, pulmonary tuberculosis was found and he hesitated on starting antituberculosis chemotherapy. He suffered from progressive pain and swelling of the right prosthetic knee for 2 months before this admission. The pathologic report of the debridement of the right prosthetic knee was caseous granulomatous inflammation with positive acid-fast staining bacilli. The culture of the debridement also yielded Mycobacterium tuberculosis. He died due to aspiration pneumonia with multiorgan dysfunction. This case is a reminder of the possibility of tuberculosis while dealing with prosthetic joint infection.
Wang
Ping-Huai
PH
Division of Thoracic Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
Shih
Kao-Shang
KS
Tsai
Chien-Chen
CC
Wang
Hao-Chien
HC
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000995:Antitubercular Agents