Adzic Tatjana, Pesu Dragica, Stojsic Jelena, Nagorni-Obradovi Ljudmila, Stevi Ruza
Clinical Centre of Serbia, Institute of Lung Diseases and Tuberculosis, Research and Epidemiology Department, Belgrade, Serbia.
Pneumologia. 2008 Jul-Sep;57(3):156-7.
Tuberculosis (TB) is declared global emergency. Miliary TB is a treatable, potentially lethal form of TB resulting from massive lympho-hematogenous dissemination of Mycobacterium tuberculosis. Impaired cell-mediated immunity underlies the disease's development. We present a case of specific synovitis in a 21-year-old Caucasian HIV-seronegative woman. She presented with high fever and swelling of the right knee. Chest radiograph revealed bilateral nodular opacities in upper pulmonary lobes and signs of pleural effusions. Sputum samples were negative for Acid Fast Bacilli (AFB) and Löwenstein-Jensen (L-J) culture negative. Diagnosis was confirmed histologically by pleural biopsy and positive L-J cultures of knee puncture, also documented by MRI. Treatment outcome was successful with anti-tuberculous drugs following standardized treatment regimen.
结核病被宣布为全球紧急情况。粟粒性肺结核是一种可治疗但有潜在致命性的结核病形式，由结核分枝杆菌大量淋巴-血行播散所致。细胞介导免疫受损是该疾病发展的基础。我们报告一例21岁白种人、HIV血清学阴性女性的特异性滑膜炎病例。她因高热和右膝肿胀就诊。胸部X线片显示双上肺叶结节状阴影及胸腔积液征象。痰涂片抗酸杆菌（AFB）阴性，罗氏培养基（L-J）培养阴性。经胸膜活检及膝关节穿刺L-J培养阳性，组织学确诊，MRI也证实了诊断。按照标准化治疗方案使用抗结核药物治疗，治疗结果成功。
