Schöllmann Hendrik, Glombitza M, Heck V, Dudda M, Steinhausen E
Klinik für Orthopädie und Unfallchirurgie, BG Klinikum Duisburg, Großenbaumer Allee 250, 47249, Duisburg, Deutschland.
Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
Unfallchirurgie (Heidelb). 2025 Mar;128(3):231-236. doi: 10.1007/s00113-024-01527-w. Epub 2025 Jan 8.
We report the case of a 66-year-old female patient with a treatment refractory disorder of wound healing of the knee, who had already been treated several times surgically and with antibiotics for several months. The examination revealed a skin defect with a fistula in the region of the knee joint. The X‑ray imaging showed an extensive bony defect of unclear etiology. After specific diagnostics for acid-resistant rod-shaped bacteria, it was possible to identify Mycobacterium tuberculosis as the causative pathogen. After antitubercular drug treatment complete healing of the lesions was observed. The bony defect could be filled with bone substitute. There was neither a history of primary foci nor of a potentially infectious environment.
我们报告了一例66岁女性患者，其膝关节伤口愈合障碍难以治疗，此前已接受多次手术及数月抗生素治疗。检查发现膝关节区域有皮肤缺损及瘘管。X线成像显示存在病因不明的广泛骨缺损。经针对抗酸杆菌的特异性诊断，确定结核分枝杆菌为致病病原体。抗结核药物治疗后，病变完全愈合。骨缺损可用骨替代物填充。患者既无原发灶病史，也无潜在感染环境。
