[Tuberculous prosthetic knee joint infection: a case report and literature review]

Rev Esp Quimioter. 2016 Aug;29(4):214-9. Epub 2016 Jun 22.
[Article in Spanish]

Abstract

Objective: Prosthetic late infection occurs in the second month after surgery in the context of haematogenous spread from another source. Prosthetic mycobacterial infection is a rare complication whose clinical management is not standardized.

Case: Patient of 77 years with no personal history except for diabetes and a prosthetic replacement of right knee with osteoarthritis three years ago. Patient goes to hospital emergency box for 6 months pain in the right knee with mechanical inflammatory signs but no fever associated. After their return within 5 days and clinical worsening is reporting growth of Mycobacterium tuberculosis in knee aspirate and antitubercular treatment is established for 9 months. Nuclear magnetic resonance imaging studies also confirmed the diagnosis of tuberculosis spondylitis in the clinical context of the patients. After surgery, M. tuberculosis was again isolated from intraoperative samples and therefore the patient received another batch of treatment for 9 months. After a year of monitoring, the development was acceptable but few months later, the patient died for cardiovascular causes. In the literature review, 15 publications with a total of 17 clinical cases of prosthetic infection by M. tuberculosis were found from 1980 to 2014.

Conclusions: Prosthetic tuberculous arthritis, although it is a rare presentation, it should be noted, especially in patients with predisposing conditions with a history of tuberculosis infection.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antitubercular Agents / therapeutic use*
  • Arthritis, Infectious / drug therapy*
  • Arthritis, Infectious / microbiology
  • Fatal Outcome
  • Female
  • Humans
  • Knee Joint*
  • Knee Prosthesis
  • Mycobacterium tuberculosis
  • Prosthesis-Related Infections / diagnostic imaging
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / microbiology
  • Spondylitis / diagnostic imaging
  • Spondylitis / drug therapy
  • Spondylitis / microbiology
  • Tuberculosis, Osteoarticular / diagnostic imaging
  • Tuberculosis, Osteoarticular / drug therapy*
  • Tuberculosis, Osteoarticular / etiology
  • Tuberculosis, Osteoarticular / microbiology

Substances

  • Antitubercular Agents