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肩胛冈结核性骨髓炎揭示HIV-1感染

Tuberculous Osteomyelitis of the Scapular Spine Revealing HIV-1 Infection.

作者信息

Idsaid Khaoula, Idalene Malika, Danaoui Khadija, Ait Driss Wiam, Elfargani Rania, Soraa Nabila, Tassi Noura

机构信息

Department of Infectious Diseases, University Hospital Mohamed VI, Marrakesh, Faculty of Medicine and Pharmacy FMPM, Cadi Ayyad University, Marrakesh 40000, Morocco.

Microbiology Laboratory, University Hospital Mohamed VI, Marrakesh 40000, Morocco.

出版信息

Trop Med Infect Dis. 2024 Dec 30;10(1):8. doi: 10.3390/tropicalmed10010008.

Abstract

Tuberculosis is no longer confined to developing nations; it persists as a significant contributor to illness and death on a global scale. The subtle clinical manifestation and association with human immunodeficiency virus infection poses obstacles for early diagnosis and management. Tuberculosis manifesting at extrapulmonary sites is relatively rare. We herein present the case of a 26-year-old patient from Cameroon with a history of pleuropulmonary tuberculosis treated in 2008, who had been taking pre-exposure prophylaxis (PrEP). The patient presented with right shoulder pain of an inflammatory type. The case was diagnosed as tuberculous osteomyelitis of the scapular spine, complicated by a deltoid abscess. Diagnosis was confirmed using computed tomography and the MTB/RIF GeneXpert test on the abscess puncture. This rare form of tuberculosis with an exceptional site revealed a HIV infection with profound immunosuppression. The patient was initiated on anti-tubercular treatment according to Moroccan recommendations.

摘要

结核病不再局限于发展中国家;在全球范围内,它仍然是导致疾病和死亡的一个重要因素。其临床表现不明显以及与人类免疫缺陷病毒感染相关,给早期诊断和治疗带来了障碍。肺外部位出现的结核病相对少见。我们在此介绍一例来自喀麦隆的26岁患者,该患者曾于2008年接受过胸膜肺结核病治疗,一直在接受暴露前预防(PrEP)。患者出现炎症性右肩疼痛。该病例被诊断为肩胛脊柱结核性骨髓炎,并伴有三角肌脓肿。通过计算机断层扫描以及对脓肿穿刺样本进行MTB/RIF GeneXpert检测确诊。这种罕见的特殊部位结核病显示患者感染了HIV且免疫功能严重抑制。根据摩洛哥的建议,该患者开始接受抗结核治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf8d/11769330/6ddc2110ab11/tropicalmed-10-00008-g001.jpg

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