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Bone and joint mycobacterial infection: a retrospective review of cases presenting to a UK district hospital.
Everden, A; Mamo, J P; Somasunderam, D; McKee, A; Brij, S O; Enoch, D A.
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  • Everden A; 1​Department of Respiratory Medicine, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Bretton Gate, Peterborough, PE3 9GZ, UK.
  • Mamo JP; 2​Snowdon Neurorehabilitation Unit, Western Community Hospital Solent NHS Trust, William Macleod Way, Southampton, SO16 4XE, UK.
  • Somasunderam D; 3​Clinical Microbiology and Public Health Laboratory, National Infection Service, Public Health England, Addenbrookes Hospital, Cambridge, CB2 2QW, UK.
  • McKee A; 4​Department of Trauma and Orthopaedic Surgery, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Bretton Gate, Peterborough, PE3 9GZ, UK.
  • Brij SO; 1​Department of Respiratory Medicine, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough City Hospital, Bretton Gate, Peterborough, PE3 9GZ, UK.
  • Enoch DA; 3​Clinical Microbiology and Public Health Laboratory, National Infection Service, Public Health England, Addenbrookes Hospital, Cambridge, CB2 2QW, UK.
J Med Microbiol ; 67(12): 1698-1705, 2018 Dec.
Article en En | MEDLINE | ID: mdl-30376445
PURPOSE: Peterborough has one of the highest rates of tuberculosis (TB) in the east of England. We reviewed the epidemiology, management and outcome of all cases of bone and joint TB (BJTB) diagnosed since 2000. METHODOLOGY: Retrospective review of all adult cases of BJTB between 1 January 2000 and 31 December 2015. Patients' notes were reviewed with regard to their presentation, investigation, management and outcomes. RESULTS: In total, 21 patients diagnosed with BJTB were reviewed. Thoracic and lumbar spine were the most common sites affected (62 %). The most common clinical manifestations included localized pain (76 %), fever (53 %) and weight loss (48 %). Fourteen (67 %) patients had a bone biopsy or aspirate sent for microbiological investigation; none were smear-positive, but 11 were culture-positive. Eleven patients (77 %) were fully susceptible to anti-tuberculous drugs, one was isoniazid-resistant and one was pyrazinamide-resistant. Anti-tuberculous therapy was given for 6-16 months. Nineteen (90 %) patients completed therapy. CONCLUSIONS: BJTB requires a high index of clinical suspicion. BJTB should be considered in any patient with unexplained pain, fever and weight loss. The diagnosis is proven by aspiration and biopsy and should be undertaken as soon as possible for culture purposes, as microscopy alone can be negative.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis Osteoarticular Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Med Microbiol Año: 2018 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis Osteoarticular Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Med Microbiol Año: 2018 Tipo del documento: Article Pais de publicación: Reino Unido