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布鲁氏菌性膝关节炎合并膝关节结核:一例报告及文献复习

Brucellar Knee Arthritis with Knee Joint Tuberculosis: A Case Report and Review of the Literature.

作者信息

Wang Jie, Li Shuguang, Zhang Qiang

机构信息

Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China.

出版信息

Infect Drug Resist. 2022 Apr 8;15:1659-1665. doi: 10.2147/IDR.S359693. eCollection 2022.

Abstract

and (MTB) primarily affect the spine and only rarely the knee joint in osteoarticular disease in adults. We present an unusual instance of brucellar knee arthritis combined with knee joint tuberculosis. A 59-year-old man was initially diagnosed with brucellar knee arthritis in the orthopedics department of our hospital, while two weeks of standardized treatment did not improve the joint discomfort and inflammation indexes. Subsequent evaluation of serum tuberculosis interferon-gamma release assays (TB-IGRAs) and the effectiveness of empirical anti-tuberculosis therapy confirmed the mixed infection of tuberculosis. This case report demonstrates that clinical signs and imaging for brucellar knee arthritis and knee joint tuberculosis are similar. Patients with both disorders are more likely to be misdiagnosed or have their diagnosis delayed; clinicians should be aware of this uncommon combination of mixed infections.

摘要

在成人骨关节炎疾病中,布鲁氏菌(MTB)主要影响脊柱,很少累及膝关节。我们报告一例罕见的布鲁氏菌性膝关节炎合并膝关节结核病例。一名59岁男性最初在我院骨科被诊断为布鲁氏菌性膝关节炎,然而两周的标准化治疗并未改善关节不适和炎症指标。随后血清结核干扰素-γ释放试验(TB-IGRAs)评估及经验性抗结核治疗的有效性证实了结核混合感染。本病例报告表明,布鲁氏菌性膝关节炎和膝关节结核的临床症状及影像学表现相似。这两种疾病的患者更易被误诊或诊断延迟;临床医生应意识到这种罕见的混合感染组合情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d935/9004727/09a865053a30/IDR-15-1659-g0001.jpg

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