圣关节结核与并发的伊利欧普索亚腹表明诊断和治疗的挑战:一个病例报告
Elissavet Symeonidou1, Ariadni Fouza1, Dimitrios Molyvas2
15th Department of Surgery, Ippokrateio General Hospital/Aristotle University of Thessaloniki, Thessaloniki, GRC.
Cureus
|December 16, 2024
概括
关节结核病 (SIJ TB) 是一种罕见的疾病,并模仿其他疾病. 这一案例突显了SIJ结核病与脑膜炎的诊断挑战和致命结果.
科学领域:
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
- 整形外科手术 整形外科手术
背景情况:
- 关节结核病 (SIJ TB) 是一种不常见的疾病,特别是在发达国家.
- 症状通常是非特异性的,导致误诊为各种退行性或非退行性疾病.
研究的目的:
- 提出一个具有挑战性的病例神结节结核病与psoas和随后的结核脑膜炎.
- 提高人们对这种罕见的实体及其复杂的诊断和治疗管理的认识.
主要方法:
- 一个77岁的男性患有长期发烧和行走困难的病例报告.
- 诊断成像包括磁共振成像 (MRI) 和计算机断层扫描 (CT).
- 侵入性手术包括CT导向吸收,开放活检和骨活检用于诊断;开始治疗抗结核病.
主要成果:
- 核磁共振扫描显示SIJ骨髓炎和双边阴茎.
- 最初的微生物学测试 (培养,Gene-Xpert) 呈阴性结果.
- 活检后,患者出现混乱和发烧,通过脑MRI诊断为结核性脑膜炎,导致ICU入院和致命恶化,尽管进行了四次抗结核治疗.
结论:
- 由于非特异性症状,SIJ结核病存在诊断困难.
- 需要积极的管理,但像中枢神经系统结核病这样的并发症可能导致不良结果.
- 早期识别和及时,适当的治疗对于控制这种罕见但严重的感染至关重要.
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