结核菌复杂化了可选的右膝关节全关节整形手术
Edward Eusanio1, Brian Shaw1, Mario Madruga1
1Internal Medicine, Orlando Regional Medical Center, Orlando, USA.
Cureus
|February 19, 2026
概括
结核假肢关节感染 (TB-PJIs) 是罕见的,通常是培养负的. 先进的测序在膝关节置换感染中发现了Mycobacterium结核病,强调了在困难的情况下需要怀疑.
科学领域:
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
- 微生物学 微生物学
背景情况:
- 结核菌菌通常会导致肺部疾病,但也会影响骨和关节等肺外部部位.
- 结核假肢关节感染 (TB-PJIs) 不常见,由于低怀疑和负面的常规培养,经常被晚诊.
- 呈现了一个培养负的假膝关节感染病例.
研究的目的:
- 报告一种罕见的Mycobacterium结核复杂假肢关节感染病例.
- 突出与TB-PJIs相关的诊断挑战和治疗并发症.
- 强调先进的分子技术在诊断培养负性感染中的实用性.
主要方法:
- 一名73岁的男性患者接受了全膝关节关节整形手术.
- 术后假肢关节感染发生,初始负面的例行培养.
- 下一代16S rRNA基因测序用于病原体识别.
主要成果:
- 下一代测序确定了结核菌复合体.
- 该患者接受了RIPE治疗,但患上了扩散性疾病,并怀疑耐药结核病.
- 并发症包括膀破裂和多器官衰竭,导致死亡.
结论:
- 结核病-PJIs可以在没有肺部症状的情况下出现,并且应考虑培养负关节感染,特别是当标准治疗失败时.
- 疑似多药性耐药性可能会使TB-PJI管理复杂化.
- 这一案例强调了先进诊断对于识别假肢关节感染中具有挑战性的病原体的重要性.
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