Martos J A, Olm M, Miró J M, Mallolas J, Letang E, Brancos M A, Gatell J M, Soriano E
Med Clin (Barc). 1989 Oct 21;93(12):467-70.
We report two cases of osteoarticular tuberculosis in heroin addict patients infected with human immunodeficiency virus. Both patients presented an inflammatory tumor in the anterior chest wall, with subacute onset; one patient had chondrosternal involvement and the other had chondrocostal involvement with a retrosternal pus collection. Diagnosis was established by needle aspiration of the tumor that gave raise to caseum. Ziehl-Neelsen stain was positive and Löwenstein-Jensen culture yielded Mycobacterium tuberculosis in both cases. The course was good after surgical debridement and tuberculous treatment for 6 months. We review the features of osteoarticular tuberculosis in drug addicts and patients infected with human immunodeficiency virus that in our environment mainly affects this population group. As in our geographical area, an increased incidence of both infections does exist and owing to the high prevalence of extrapulmonary and disseminated tuberculosis in those patients, it is expected that in a future time, the number of cases of tuberculosis will increase. Therefore, physicians must entertain a high degree of suspicion with the purpose of establishing an early diagnosis of these atypic presenting forms.
我们报告了两例感染人类免疫缺陷病毒的海洛因成瘾患者发生骨关节结核的病例。两名患者均在前胸壁出现炎性肿物，起病亚急性；一名患者累及胸骨柄，另一名患者累及肋软骨并伴有胸骨后积脓。通过对肿物进行针吸活检抽出干酪样物质而确诊。萋-尼染色呈阳性，在两例患者中罗-琴培养均培养出结核分枝杆菌。手术清创并进行6个月的抗结核治疗后病情好转。我们回顾了吸毒者和感染人类免疫缺陷病毒患者中骨关节结核的特征，在我们所处环境中，这主要影响这一人群。正如在我们所在地理区域，这两种感染的发病率确实有所上升，并且由于这些患者肺外及播散性结核的高患病率，预计未来结核病病例数将会增加。因此，医生必须高度怀疑，以便对这些非典型表现形式尽早做出诊断。
