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

Giuliana Carrega1, Valentina Bartolacci, Giorgio Burastero

  • 1Department of Infectious Diseases and Septic Orthopedic Surgery, "Polo del Ponente Ligure", Pietra Ligure, Albenga, Italy.

International Journal of Surgery Case Reports
|January 2, 2013
PubMed
Abstract

Insights

Periprosthetic joint infections caused by tuberculosis are rising and often misdiagnosed. Early diagnosis through aggressive methods like tissue culture is crucial to prevent permanent functional damage.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Microbiology

Background:

  • Tubercular infection of prosthetic joints is uncommon but increasing.
  • Clinical presentation is often atypical, leading to frequent misdiagnosis as bacterial infections.

Purpose of the Study:

  • To highlight the challenges in diagnosing and treating prosthetic joint infections caused by Mycobacterium tuberculosis.
  • To emphasize the need for a high index of suspicion and specific diagnostic approaches.

Main Methods:

  • Case series of five patients (1 hand, 2 hip, 2 knee) with prosthetic joint infections due to Mycobacterium tuberculosis.
  • Diagnosis confirmed by periprosthetic tissue culture and histopathological examination.
  • Initial misdiagnosis as bacterial infection and prolonged antibiotic treatment in all cases.

Main Results:

  • All patients were treated for tuberculosis, achieving cure.
  • Two patients experienced permanent functional deficits (knee arthrodesis, hand function loss) due to delayed diagnosis and treatment.
  • Initial antibiotic therapy for presumed bacterial infection was ineffective.

Conclusions:

  • An aggressive diagnostic strategy, including specific cultures for tuberculosis, is essential for periprosthetic joint infections.
  • Early identification of Mycobacterium tuberculosis and drug susceptibility testing are critical.
  • A low threshold for suspecting tuberculosis in prosthetic joint infections can prevent long-term complications.

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