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一名血液透析患者的结核性关节炎。

Tuberculous arthritis in a hemodialysis patient.

作者信息

Haskell L P, Tannenberg A M

机构信息

Department of Medicine, Metropolitan Hospital Center, New York, N.Y.

出版信息

Am J Nephrol. 1987;7(5):404-7. doi: 10.1159/000167509.

Abstract

Tuberculosis (TB) is a relatively common infectious complication in the dialysis population. Most cases are extrapulmonary and pose a diagnostic dilemma for the clinician. Tuberculous arthritis is a rare form of extrapulmonary TB occurring in approximately 1% of cases in nonuremics. Only 1 case in a dialysis patient (not proven by positive synovial fluid culture) has been reported. We report here a culture-proven case of tuberculous arthritis in a hemodialysis patient which masqueraded as an acute septic arthritis. TB should be considered early as an etiologic agent along with synovial biopsy when the exact cause of a monoarthritis has not been discovered, thus avoiding delay in initiation of appropriate therapy.

摘要

结核病(TB)是透析人群中相对常见的感染性并发症。大多数病例为肺外结核,给临床医生带来诊断难题。结核性关节炎是肺外结核的一种罕见形式,在非尿毒症患者中约1%的病例会出现。透析患者中仅报告过1例(滑膜液培养未证实)。我们在此报告1例经培养证实的血液透析患者结核性关节炎病例,该病例曾被误诊为急性化脓性关节炎。当单关节炎的确切病因尚未明确时,应尽早考虑将结核作为病因之一,并同时进行滑膜活检,从而避免延误适当治疗的开始。

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