Disseminated Tuberculosis Following Total Knee Arthroplasty in an HIV Patient

Marschall, J; Evison, J-M; Droz, S; Studer, U C; Zimmerli, S (2008). Disseminated Tuberculosis Following Total Knee Arthroplasty in an HIV Patient. Infection, 36(3), pp. 274-278. Heidelberg: Urban & Vogel 10.1007/s15010-007-7011-1

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Skeletal tuberculosis is now uncommon in developed countries. In immunocompromised patients - particularly in the HIV-infected - who present with subacute or chronic joint pain refractory to conventional treatment, osteoarticular tuberculosis should still be included in the differential diagnosis. We report on a lethal case of disseminated tuberculosis in an HIV-infected subject. Dissemination may have resulted from the implantation of an articular prosthesis in a knee joint with unsuspected osteoarticular tuberculosis. The diagnosis was established months later when the patient presented with far-advanced tuberculous meningitis, miliary tuberculosis of the lungs, femoral osteomyelitis and extended cold abscesses along the femoral shaft. Failure to respond to a conventional four-drug regimen is explained by the resistance pattern of his multi-drug resistant strain of Mycobacterium tuberculosis, which was only reported after the patient's death. This case illustrates the diagnostic challenges of osteoarticular tuberculosis and the consequences of a diagnostic delay in an HIV-infected individual.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases

UniBE Contributor:

Marschall, Jonas; Evison, John Marc and Zimmerli, Stefan

ISSN:

0300-8126

ISBN:

18084716

Publisher:

Urban & Vogel

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:56

Last Modified:

07 Sep 2020 08:50

Publisher DOI:

10.1007/s15010-007-7011-1

PubMed ID:

18084716

Web of Science ID:

000256795400015

BORIS DOI:

10.7892/boris.23942

URI:

https://boris.unibe.ch/id/eprint/23942 (FactScience: 45295)

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