Institute of Clinical Infectious Disease, Catholic University of the Sacred Heart, Rome, Italy.
Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
Am J Trop Med Hyg. 2019 Sep;101(3):494-497. doi: 10.4269/ajtmh.19-0262.
We report a case of a 13-year-old immunocompetent male with multifocal tubercular osteomyelitis involving several spinal segments, small bones of the hands, and the scalp, who started with progressively back pain and enlarging painful swelling on the palms of hands, fatigue, and irregular fever. All the hand lesions were firm, mildly tender, and covered by ulcerated skin with serous discharge from the site. Magnetic resonance showed lesions of the right fifth metacarpal, of the right intermediate phalanx of the fourth finger, of the left second metacarpal, and of most vertebral bodies of the cervical, dorsal, lumbar, and sacral spine. The nucleic acid amplification test and the final culture from the drainage of the hands' lesion were positive for . The patient received a standard antitubercular treatment for 12 months with clinical improvement.
我们报告了一例 13 岁免疫功能正常的男性，患有多处结核性骨髓炎，累及多个脊柱节段、手部小骨和头皮，最初表现为进行性背痛和手掌上增大的疼痛性肿胀、疲劳和不规则发热。所有手部病变均为坚实、轻度压痛，病变表面覆盖有溃疡性皮肤，有浆液性分泌物渗出。磁共振成像显示右手第五掌骨、右手第四指中节指骨、左手第二掌骨以及颈椎、胸椎、腰椎和骶骨的大多数椎体均有病变。手部病变引流液的核酸扩增试验和最终培养结果均为阳性。该患者接受了为期 12 个月的标准抗结核治疗，临床症状有所改善。
