Department of Occupational Respiratory Diseases, Okayama Rosai Hospital, Okayama, Japan.
J Infect Chemother. 2010 Feb;16(1):53-5. doi: 10.1007/s10156-009-0010-7. Epub 2010 Jan 6.
Tuberculosis is a leading cause of mortality due to an infectious agent worldwide. It often affects multiple organs by hematogenous spread of Mycobacterium tuberculosis, but knee-joint involvement is extremely rare, comprising approximately 0.1% of all forms of tuberculosis. We present a case of tuberculous pleuritis with knee-joint involvement. Cytological and biochemical analysis of the pleural fluid and a biopsy specimen of the cervical lymph node indicated tuberculosis, but a definitive diagnosis was not given. A confirmed diagnosis was finally obtained through PCR analysis of the synovial fluid. Tuberculosis should be included in the differential diagnosis in patients with persistent pain and swelling of the knee. PCR analysis of the synovial fluid is a quick and useful method for the diagnosis.
结核病是全球范围内因感染因子导致死亡的主要原因。它通常通过血源性传播累及多种器官,但膝关节受累极为罕见,约占所有结核病形式的 0.1%。我们报告了一例结核性胸膜炎合并膝关节受累。胸腔积液的细胞学和生化分析以及颈部淋巴结活检均提示结核病,但未明确诊断。最终通过关节液 PCR 分析确诊。对于持续性膝关节疼痛和肿胀的患者,应将结核病纳入鉴别诊断。关节液 PCR 分析是一种快速有用的诊断方法。