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Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
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Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Tubercular prosthetic knee joint infection.

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    Area of Science:

    • Orthopedics
    • Infectious Diseases
    • Rheumatology

    Background:

    • Latent tuberculosis infection (LTBI) treatment may not fully prevent reactivation.
    • Total knee arthroplasty (TKA) presents a unique challenge for prosthetic joint infections (PJIs).
    • Optimal management strategies for tubercular PJIs remain undefined.

    Observation:

    • A rare case of late-onset tubercular infection post-TKA is presented in a 60-year-old woman with a history of treated LTBI.
    • Tubercular PJIs can manifest as early-onset (within 6-8 weeks) or late-onset (after 8 weeks) presentations.
    • Late-onset tubercular PJI in this case occurred nearly 25 years after initial LTBI treatment.

    Findings:

    • Early-onset tubercular PJI may respond to antitubercular chemotherapy alone.
    • Late-onset tubercular PJI often necessitates a two-stage reimplantation procedure.
    • Antitubercular medications are crucial for managing both early and late-onset presentations.
    • Adequate LTBI treatment does not eliminate the risk of subsequent prosthetic joint infection.

    Implications:

    • A treatment algorithm for tubercular PJIs based on presentation timing is proposed.
    • Patients with a history of LTBI require careful monitoring post-TKA.
    • Further research is needed to refine management protocols for rare tubercular PJIs.
    • This case underscores the persistent risk of infection despite previous adequate treatment for latent tuberculosis.