双边手指甲状炎:伟大的模仿者的不寻常呈现:结核病
Dilara Bulut Gökten1, Fatma Yümün Kavak2, Rıdvan Mercan1
1Department of Rheumatology, Tekirdag Namik Kemal University, Tekırdag, Turkey.
Modern rheumatology case reports
|January 16, 2024
概括
肺外结核是一种罕见的疾病,可以影响手和脚. 早期诊断和适当的治疗对于管理这种具有挑战性的结核病形式至关重要.
科学领域:
- 医学 医学 医学 医学 医学
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 由于有效的药物和改善的社会经济因素,发达国家结核病发病率有所下降.
- 外肺结核病例 (EPTB) 与全球结核病例相比显著减少,受全球旅行的影响较小.
- 结核性甲状腺炎是一种罕见的骨质炎形式,主要影响儿童的手和脚骨,也被称为"脊柱".
研究的目的:
- 报道了一例罕见的结核牙炎病例,该病例发生在一名42岁的男性身上,手部关节胀和疼痛.
- 突出成人肺外结核的诊断挑战和治疗考虑因素.
- 强调在影响四肢的慢性炎症状况的差异诊断中考虑结核病的重要性.
主要方法:
- 评估了一名42岁的男性患者,他有一年的手关节胀和疼痛病史.
- 该患者之前曾接受过包括莱夫卢诺胺,甲基prednisolone,甲醇和硫素在内的治疗,但没有改善.
- 诊断工作包括皮肤学检查,伤口培养,Quantiferon测试和真菌菌培养.
主要成果:
- 尽管先前对疑似炎症性关节炎进行了广泛的治疗,但患者的病情持续并恶化.
- 皮肤病学发现包括手上出血的皮层斑块和斑块.
- 菌根菌培养证实了Mycobacterium结核综合体的存在,并且Quantiferon测试呈阳性.
结论:
- 这一案例强调了在慢性手部疾病的差异诊断中考虑肺外结核的重要性,即使在成年人中也是如此.
- 及时的微生物学确认对于准确诊断和有效治疗结核性指甲炎至关重要.
- 成功识别了Mycobacterium结核复合体,强调了在非流行性环境中诊断EPTB时需要保持警.
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