Prosthetic joint infections due to Mycobacterium tuberculosis: A report of 5 cases

Abstract

INTRODUCTIONTubercular infection of prosthetic joint arthroplasty is sporadically described, but its incidence is rising. Misdiagnosis is common because of disparate clinical presentation. PRESENTATION OF CASEWe describe 1 hand, 2 hip and 2 knee prosthetic-joint infections due to Mycobacterium tuberculosis in patients without a previous history of tuberculosis. All of them were initially misdiagnosed as bacterial infections and unsuccessfully treated with antibiotic for a long period of time. Diagnosis was made by means of culture of periprosthetic tissues and histolopathological examination. Tuberculosis was cured in all patients, but two of them have had a permanent functional damage (one arthrodesis of the knee and one loss of hand function). DISCUSSIONAn aggressive diagnostic approach is required to make diagnosis of periprosthetic tubercular infection. The identification of the pathogen is advisable to test drug susceptibility. CONCLUSIONThe low index of suspicion of periprosthetic tubercular infection could delay a correct diagnosis with risk of permanent damage due to a late treatment. During any surgical revision of prosthetic joints with suspect infection culture for tuberculosis should be taken into consideration.