Hodkinson B, Osman N, Botha-Scheepers S
Department of Medicine, Division of Rheumatology, University of Cape Town and Groote Schuur Hospital, Cape Town 7945, South Africa.
Division of Anatomical Pathology, National Health Laboratory Service, University of Cape Town and Groote Schuur Hospital, Cape Town 7945, South Africa.
Case Rep Rheumatol. 2016;2016:5718423. doi: 10.1155/2016/5718423. Epub 2016 May 26.
We report the case of a 47-year-old female patient with rheumatoid arthritis and HIV infection presenting with a 3-week history of a painful swollen knee, increased serum inflammatory markers, and a low CD4 lymphocyte count. The diagnosis of TB arthritis was made by synovial fluid culture, GeneXpert/PCR, and confirmed by histopathology of a synovial biopsy. A mini literature review suggests that although HIV infection is associated with extrapulmonary TB, osteoarticular TB is a relatively unusual presentation in an HIV positive patient. The diagnostic utility of the GeneXpert test is explored. We also describe the patient's good response to an intra-articular corticosteroid injection in combination with standard anti-TB therapy.
我们报告了一例47岁患有类风湿性关节炎和HIV感染的女性患者，其出现膝关节疼痛肿胀3周病史、血清炎症标志物升高以及CD4淋巴细胞计数低。通过滑液培养、GeneXpert/聚合酶链反应（PCR）诊断为结核性关节炎，并经滑膜活检的组织病理学证实。一项小型文献综述表明，尽管HIV感染与肺外结核相关，但骨关节结核在HIV阳性患者中是一种相对不常见的表现。探讨了GeneXpert检测的诊断效用。我们还描述了该患者对关节内注射皮质类固醇联合标准抗结核治疗的良好反应。
