一名患有粟粒性和骨关节结核的5岁男孩。
A 5-year-old boy with miliary and osteoarticular tuberculosis.
作者信息
Washington Charles Henry, Oberdorfer Peninnah
机构信息
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
出版信息
BMJ Case Rep. 2014 May 28;2014:bcr2014204217. doi: 10.1136/bcr-2014-204217.
Osteoarticular involvement is one manifestation of extrapulmonary tuberculosis (TB). We present a 5-year-old Burmese boy with 10 months of right hip pain and decreased range of motion. The patient also had low-grade fever, cough and decreased appetite. The patient was undocumented and had recently moved from Myanmar. He was thin, in moderate distress with bilateral lung rhonchi, mild subcostal retractions, low back pain, right hip tenderness and painful and limited right range of motion. The patient's chest and pelvis radiographs showed a miliary pattern and right acetabulum osteolytic lesions, respectively. He was started on anti-TB medication and cefotaxime. Ofloxacin was added because of the concern of drug-resistant TB. The patient underwent a right hip debridement. His symptoms improved markedly, with improved mobility. TB is a challenging infection to diagnose, which can cause significant delays in management.
骨关节受累是肺外结核（TB）的一种表现形式。我们报告一名5岁的缅甸男孩，有10个月的右髋部疼痛及活动范围减小。该患者还伴有低热、咳嗽和食欲减退。患者身份不明，最近刚从缅甸迁来。他体型消瘦，中度痛苦，双侧肺部有啰音，轻度肋下凹陷，腰痛，右髋部压痛，右髋活动疼痛且范围受限。患者的胸部和骨盆X线片分别显示粟粒样改变和右髋臼溶骨性病变。他开始接受抗结核药物和头孢噻肟治疗。由于担心耐药性结核，加用了氧氟沙星。患者接受了右髋清创术。他的症状明显改善，活动能力增强。结核是一种难以诊断的感染性疾病，可能导致治疗的显著延迟。
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