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Delayed Presentation of Shoulder Tuberculosis

机译:肩部结核的延迟诊治

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Infections caused by Mycobacterium tuberculosis (MTb) have a global distribution, with infections occurring most frequently in persons residing in or who have resided in developing nations. Pulmonary tuberculosis (Tb) is the most common form of infection caused by MTb. Osteoarticular Tb is a far less common condition than pulmonary Tb and is frequently overlooked in the differential diagnosis of persons with joint pathology. Osteoarticular Tb infections are far less common than pulmonary Tb and are usually not considered in the differential diagnosis. We describe a case of a 57-year-old immigrant African male who presented with 5 years of right shoulder pain and a restricted range of movement. Magnetic resonance imaging (MRI) concluded right shoulder septic arthritis, for which he underwent operative drainage and debridement was undertaken. The thick purulent joint fluid subsequently yielded MTb, establishing the diagnosis of osteoarticular Tb. We conclude that Tb should be suspected in cases of long-standing joint pain and stiffness, particularly in persons from endemic areas with Tb as well as patients with a previous history of Tb exposure.
机译:结核分枝杆菌(MTb)引起的感染在全球范围内分布,感染最常发生在发展中国家或居住在发展中国家的人。肺结核(Tb)是由MTb引起的最常见的感染形式。骨关节Tb是远不如肺Tb常见的疾病,在关节病变患者的鉴别诊断中经常被忽视。骨关节Tb感染远不及肺Tb常见,在鉴别诊断中通常不考虑。我们描述了一个57岁的非洲移民男性病例,该男性患有5年的右肩痛和活动受限。磁共振成像(MRI)总结为右肩部化脓性关节炎,对此他进行了手术引流和清创术。浓稠的化脓性关节液随后产生MTb,从而诊断出骨关节Tb。我们得出结论,在长期存在关节疼痛和僵硬的情况下,尤其在来自Tb流行地区的人以及以前有Tb暴露史的患者中,应怀疑Tb。

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