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Is bacterial culture enough for chronic infection after total knee arthroplasty? A case report of tuberculous prosthetic infection with concomitant infection
並列摘要
Total knee arthroplasty (TKA) has become a conventional treatment method for patients with severe knee diseases. Here, we present a case of prosthetic joint infection with tuberculosis (TB) and a concomitant pathogen after TKA. A 71-year-old man who had undergone TKA 7 years previously experienced pain and discharge in the knee region The joint was first debrided, but the patient's symptoms persisted despite the presence of negative bacterial cultures. He was therefore referred to our hospital where prosthesis removal and debridement were performed, and multiple samples for bacterial and TB culture were collected. Streptococcus was first isolated and the patient received appropriate antibiotic therapy. However, despite symptom improvement, C-reactive protein level and erythrocyte sedimentation rate remained abnormal. Subsequent isolation of TB organisms and treatment with TB mediation resulted in normalization of these parameters. Allograft bone transplantation and subsequent revision arthroplasty were performed. TB may be diagnosed using culture or histological examination, as well as polymerase chain reaction testing if available. Concomitant TB infection should be suspected when a patient experiences only limited improvement under antibiotic treatment for an already recognized pathogen. Early TB culture is important for timely diagnosis and treatment.
延伸閱讀
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