Tokumoto J I, Follansbee S E, Jacobs R A
Department of Medicine, University of California, San Francisco, USA.
Clin Infect Dis. 1995 Jul;21(1):134-6. doi: 10.1093/clinids/21.1.134.
Prosthetic joint infection due to Mycobacterium tuberculosis is uncommon. We describe three patients with delayed tuberculous prosthetic joint infection and review the eight other cases reported in the English-language literature. Infection results from local reactivation, which can occur up to 40 years after the initial infection, or from hematogenous spread. The diagnosis is often delayed because it is not considered in the initial evaluation, because it is difficult to confirm microbiologically, or because other bacteria may be isolated from the synovial fluid and thus be considered the etiology of the infection. Treatment usually consists of removal of the prosthesis in addition to administration of antituberculous agents.
结核分枝杆菌所致的人工关节感染并不常见。我们描述了3例迟发性结核性人工关节感染患者，并回顾了英文文献中报道的其他8例病例。感染是由局部再激活引起的，这种情况可在初次感染后长达40年发生，也可由血行播散引起。诊断往往会延迟，原因包括在初始评估时未考虑到该病、微生物学确诊困难，或者因为从滑液中分离出了其他细菌，从而认为这些细菌是感染的病因。治疗通常除了给予抗结核药物外，还包括取出假体。
