Miliary tuberculosis with delayed-onset total knee arthroplasty Mycobacteria tuberculosis infection successfully treated with medical therapy alone: A case report and literature review |
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| Institution: | 1. Division of Infectious Diseases, Department of Internal Medicine, King Saud University, Riyadh, Saudi Arabia;2. Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia;1. Department of Orthopedics, Changhai Hospital Affiliated to Second Military Medical University, Shanghai, China;2. The Orthopedics Department, NO.515 Hospital of PLA, Wuxi, China;1. Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium;2. Department of Orthopedic Surgery, AZ Vesalius, Tongeren, Belgium;3. GRIT Belgian Sports Clinic, Leuven, Belgium;4. Monica Orthopedic Research (MoRe) Foundation, Monica Hospital, Antwerp, Belgium;5. I-BioStat, University of Hasselt, Diepenbeek, Belgium;6. Department of Orthopedic Surgery, ZOL Genk, Genk, Belgium;1. Sana Klinikum Rummelsberg, Department of Orthopaedic Surgery, Rummelsberg 71, 90592 Schwarzenbruck, Germany;2. Department of Orthopaedics, RWTH University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany;1. Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada;2. Population Data BC, University of British Columbia, Vancouver, BC, Canada;3. UBC MRI Research Centre, University of British Columbia, Vancouver, BC, Canada;4. Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada;5. Department of Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada;6. Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada;7. Department of Orthopaedics and Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada;8. Vancouver Coastal Health Research Institute, Vancouver, BC, Canada;9. School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada;10. NeuralSeg Ltd, Hamilton, ON, Canada |
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| Abstract: | Tuberculosis (TB) affecting a prosthetic knee is an unusual and diagnostically challenging presentation of this disease. This study reported a case of an 80-year-old man with a left total knee arthroplasty (TKA) performed eight years before his presentation. He presented with left knee swelling and pain for one month. Knee X-rays showed a normal joint space with no loosening of his prosthesis. His chest X-ray showed miliary disease, and microbiological studies of his sputum and synovial fluid aspirate grew Mycobacteria tuberculosis complex. He was successfully medically treated with anti-tuberculous therapy alone for one year. His knee hardware was retained, and he did not require debridement, resection, or revision. It is believed that this is the first reported case of miliary TB with delayed-onset TKA prosthetic joint infection (PJI) in which the prosthesis was successfully retained. Thirty-eight published TB TKA PJI cases in medical literature were also reviewed. |
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