A Case of Miliary Tuberculosis Complicated by Knee Joint Tuberculosis

This case report details a 75-year-old male diagnosed with miliary tuberculosis (TB) who subsequently developed tuberculous arthritis in his left knee. The patient was initially admitted for a hemorrhagic gastric ulcer, where chest imaging and positive cultures from multiple sites confirmed miliary TB. Standard antitubercular therapy was started, but 6 weeks later, he presented with worsening pain and swelling in his left knee. A joint aspiration and MRI confirmed tuberculous arthritis with an abscess, which necessitated surgical debridement in addition to the drug regimen. We emphasize that orthopaedic TB often requires surgical intervention alongside medication for successful treatment. While total knee arthroplasty can be an effective treatment for joint destruction, the previous report suggests that it should be delayed until after a prolonged course of antitubercular therapy (e.g., 12 months or more) to prevent recurrence.