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[Osteoarticular tuberculosis. Diagnostic contribution of local sampling]
F Lemaître1, R Damade, J Pouchot
1Service de médecine interne V, hôpital Louis-Mourier, Colombes, France.
La Revue De Medecine Interne
|January 1, 1995
Summary
Diagnosis of bone and joint tuberculosis can be confirmed through local sampling, with pathological and microbiological examinations proving highly effective. Early diagnosis and treatment lead to favorable outcomes in all patients.
Area of Science:
- Orthopedics
- Infectious Diseases
- Microbiology
Context:
- Bone and joint tuberculosis (BJT) incidence is increasing, particularly with the spread of HIV infection.
- BJT is often pauci-bacillary, necessitating local sampling for diagnosis.
- Accurate diagnosis is crucial for early therapeutic intervention.
Purpose:
- To evaluate the diagnostic yield of local sampling in bone and joint tuberculosis.
- To assess the effectiveness of pathological and microbiological examinations in diagnosing BJT.
- To review treatment outcomes for patients with BJT.
Summary:
- A study of 19 patients with bone and joint tuberculosis from 1983-1992.
- Seventeen local samples (12 biopsies, 5 abscess punctures) were analyzed.
- Pathology confirmed tuberculosis in 8/12 cases; microbiological analysis (smear, culture) yielded diagnosis in 11/12 cases.
- Bacteriological and pathological examinations were non-contributory in only one patient.
- Microbiological examination of pus showed 2 positive direct smears and 3 positive cultures.
Impact:
- Local sampling, combining pathological and microbiological analyses, is highly effective for diagnosing bone and joint tuberculosis.
- Early diagnosis and treatment (9-18 months) resulted in favorable outcomes for all studied patients.
- This study highlights the importance of invasive sampling for pauci-bacillary forms of tuberculosis.