一例耻骨联合及耻骨结核持续不愈的病例。
A persistent case of tuberculosis of the pubic symphysis and pubic bone.
作者信息
Dapunt Ulrike, Mischnik Alexander, Goeppinger Stephan, Lehner Burkhard
机构信息
Department of Orthopaedics and Trauma Surgery, Heidelberg University, Heidelberg, Germany.
出版信息
BMJ Case Rep. 2014 Mar 10;2014:bcr2013203456. doi: 10.1136/bcr-2013-203456.
A case of a patient suffering from tuberculosis of the pubic symphysis and pubic bone is presented. There were no symptoms other than pain in the right groin area for 12 months. An X-ray of the pelvis showed an osteodestructive lesion of the pubic bone, and an MRI revealed an abscess formation of the pubic symphysis. Tissue samples were collected via CT-guided needle biopsy. Histological evaluation of tissue and analysis by PCR prompted the diagnosis of musculoskeletal tuberculosis. Despite antituberculous chemotherapy according to the current guidelines, the osteodestructive lesion progressed. This case highlights the difficulty of treating bone infections in general. Moreover, Mycobacterium tuberculosis as a rare causative agent of bone infections is discussed.
本文报告一例耻骨联合和耻骨结核患者。除右腹股沟区疼痛12个月外，无其他症状。骨盆X线显示耻骨骨质破坏病变，MRI显示耻骨联合处有脓肿形成。通过CT引导下针吸活检采集组织样本。组织的组织学评估和PCR分析提示为肌肉骨骼结核。尽管按照现行指南进行了抗结核化疗，但骨质破坏病变仍有进展。该病例凸显了一般骨感染治疗的困难。此外，还讨论了结核分枝杆菌作为骨感染罕见病原体的情况。
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