title: Pulmonary tuberculosis with delayed tuberculosis infection of total knee arthroplasty.
abstract: 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.
authors.affiliation: Division of Thoracic Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Ping-Huai
authors.initials: PH
authors.lastname: Wang
authors.forename: Kao-Shang
authors.initials: KS
authors.lastname: Shih
authors.forename: Chien-Chen
authors.initials: CC
authors.lastname: Tsai
authors.forename: Hao-Chien
authors.initials: HC
authors.lastname: Wang
mesh_terms: 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
chemical_list: D000995:Antitubercular Agents