An unusual cause of prosthetic joint infection: Mycobacterium tuberculosis

Abstract

Mycobacterium tuberculosis is a rare cause of prosthetic joint infection. Early diagnosis is critical for a good treatment response. Here, we report a case of prosthetic joint infection due to M.tuberculosis. A32-year old woman was admitted to our clinic for fever and drainage of right hip with prosthesis. After several interventions, she was diagnosed as prosthetic infection due to M.tuberculosis. Although the diagnosis was delayed because of the difficulties to yield M.tuberculosis, the outcome was good with medical therapy for 12-month and staged exchange of prosthesis. Approach to diagnosis must involve the histopathological examination of the tissue, mycobacterial cultures and acid-fast staining and when repeated cultures and examination of histological samples from infected joints are negative, tuberculosis should be kept in mind in the differential diagnosis of prosthetic joint infection. While the treatment modalities vary in English literature, it is clear that treatment must involve both medical and surgical approaches.

Keywords

• -

An unusual cause of prosthetic joint infection: Mycobacterium tuberculosis

Öz

Anahtar Kelimeler

• -

References

1. Wang PH, Shih KS, Tsai CC, Wang HC. Pulmonary tubercu- losis with delayed tuberculosis infection of total knee arthro- plasty. J Formos Med Assoc 2007;106:82-85.
2. Spinner RJ, Sexton DJ, Goldner RD, Levin LS. Periprosthetic infections due to Mycobacterium tuberculosis in patients with no prior history of tuberculosis. J Arthroplasty 1996;11:217- 222.
3. Khater FJ, Samnani IQ, Mehta JB, Moorman JP, Myers JW. Prosthetic joint infection by Mycobacterium tuberculosis: an unusual case report with literature review. South Med J 2007;100:66-69.
4. Trampuz A, Zimmerli W. Prosthetic joint infections: update in diagnosis and treatment Swiss Med Wkly 2005; 135:243- 251.
5. McCullough CJ. Tuberculosis as a late complication of total hip replacement. Acta Orthop Scand 1977; 48:508-510.
6. Zeiger LS, Watters W, Sherk H. Scintigraphic detection of prosthetic joint and soft tissue sepsis secondary to tubercu- losis. Clin Nucl Med 1984; 9:638-639.
7. Levin ML. Miliary tuberculosis masquerading as late infection in total hip replacement. Md Med J 1985; 34:153-155.
8. Wolfgang GL. Tuberculosis joint infection following total knee arthroplasty. Clin Orthop 1985;201:162-166.

9. Baldini N, Toni A, Greggi T, Giunti A. Deep sepsis from My- cobacterium tuberculosis after total hip replacement. Case report. Arch Orthop Trauma Surg 1988; 107:186-188.
10. Bryan WJ, Doherty JH Jr, Sculco TP. Tuberculosis in a rheu- matoid patient. A case report. Clin Orthop 1982; 171:206- 208.
11. Lusk RH, Wienke EC, Milligan TW, Albus TE. Tuberculous and foreign-body granulomatous reactions involving a total knee prosthesis. Arthritis Rheum 1995; 38:1325-1327.
12. Al-Shaikh R, Goodman SB. Delayed onset Mycobacterium tuberculosis infection with staphylococcal superinfection af- ter total knee replacement. Am J Orthop 1995;32:302-305.
13. Ueng WN, Shih CH, Hseuh S. Pulmonary tuberculosis as a source of infection after total hip arthroplasty. A report of two cases. Int Orthop 1995;19:55-59.
14. Tokumoto JI, Follansbee SE, Jacobs RA. Prosthetic joint in- fection due to Mycobacterium tuberculosis: Report of three cases. Clin Infect Dis 1995; 21:134-136.
15. Kreder HJ, Davey JR. Total hip arthroplasty complicated by tuberculous infection. J Arthroplasty 1996; 11:111-114.
16. Carlsson AS, Sanzén L, Mikulowski P. Bilateral tuberculous infection of replaced hips-reactivation 54 years after infection in one knee. Acta Orthop Scand 1997; 68:74-76.
17. Berbari EF, Hanssen AD, Duffy MC, Steckelberg JM, Osmon DR. Prosthetic joint infection due to Mycobacterium tubercu- losis: a case series and review of the literature. Am J Orthop 1998; 27:219-227.
18. Krappel FA, Harland U. Failure of osteosynthesis and pros- thetic joint infection due to Mycobacterium tuberculosis fol- lowing a subtrochanteric fracture: a case report and review of the literature. Arch Orthop Trauma Surg 2000; 120:470-472.
19. Fernandez-Valencia JA, Garcia S, Riba J. Presumptive infec- tion of a total hip prosthesis by Mycobacterium tuberculosis: A case report. Acta Orthop Belg 2003; 69:193-196.
20. Boeri C, Gaudias J, Jenny JY. Total hip replacement prosthe- sis infected by Mycobacterium tuberculosis. Rev Chir Orthop 2003; 89: 163-166.
21. Marmor M, Parnes N, Dekel S. Tuberculosis infection compli- cating total knee arthroplasty: report of 3 cases and review of the literature. J Arthroplasty 2004; 19:397-400.
22. Shanbhag V, Kotwal R, Gaitonde A, Singhal K. Total hip replacement infected with Mycobacterium tuberculosis A case report with review of literature. Acta Orthop Belg 2007; 73:268-274.