Rev Esp Quimioter 2016, 29(4):214-219
Tuberculous prosthetic knee joint infection: a case report and literature review
ANA LARA-OYA, Mª DEL CARMEN LIÉBANA-MARTOS, JAVIER RODRÍGUEZ-GRANGER, ANTONIO SAMPEDRO-MARTÍNEZ, LUIS ALIAGA-MARTÍNEZ, JOSÉ GUTIERREZ-FERNÁNDEZ, JOSÉ Mª NAVARRO-MARÍ
Introduction. Prosthetic late infection occurs in the second month after surgery in the context of haematogenous spread from another source. Prosthetic mycobacterial infection is a rare complication whose clinical management is not standardized.
Case. Patient of 77 years with no personal history except for diabetes and a prosthetic replacement of right knee with osteoarthritis three years ago. Patient goes to hospital emergency box for 6 months pain in the right knee with mechanical inflammatory signs but no fever associated. After their return within 5 days and clinical worsening is reporting growth of Mycobacterium tuberculosis in knee aspirate and antitubercular treatment is established for 9 months. Nuclear magnetic resonance imaging studies also confirmed the diagnosis of tuberculosis spondylitis in the clinical context of the patients. After surgery, M. tuberculosis was again isolated from intraoperative samples and therefore the patient received another batch of treatment for 9 months. After a year of monitoring, the development was acceptable but few months later, the patient died for cardiovascular causes. In the literature review, 15 publications with a total of 17 clinical cases of prosthetic infection by M. tuberculosis were found from 1980 to 2014.
Conclusion. Prosthetic tuberculous arthritis, although it is a rare presentation, it should be noted, especially in patients with predisposing conditions with a history of tuberculosis infection.
Rev Esp Quimioter 2016; 29(4):214-219 [pdf]