Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges

An 85-year-old woman with a history of total knee replacements for osteoarthritis in the past, presented with left knee swelling and pain that persisted for 14 months. An initial diagnosis of synovial cyst was made, and she underwent multiple aspirations and symptomatic treatments without improvemen...

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Main Authors: Asbah Rahman, Aastha Randhawa, Yu Shia Lin
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214250924002105
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author Asbah Rahman
Aastha Randhawa
Yu Shia Lin
author_facet Asbah Rahman
Aastha Randhawa
Yu Shia Lin
author_sort Asbah Rahman
collection DOAJ
description An 85-year-old woman with a history of total knee replacements for osteoarthritis in the past, presented with left knee swelling and pain that persisted for 14 months. An initial diagnosis of synovial cyst was made, and she underwent multiple aspirations and symptomatic treatments without improvement. Repeat arthrocentesis showed a WBC of 56,000/μL with 61 % neutrophils and 34 % lymphocytes. Synovial fluid bacterial and fungal cultures were negative. The acid-fast bacilli (AFB) culture revealed the Mycobacterium tuberculosis complex and was confirmed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) Mass Spectrometry. This case highlights the challenges of diagnosing tuberculous prosthetic joint infection in an elderly individual with knee pain.
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spelling doaj-art-e75c7a9d13d74340b349ee67e4a232792025-08-20T02:52:56ZengElsevierIDCases2214-25092025-01-0139e0213410.1016/j.idcr.2024.e02134Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challengesAsbah Rahman0Aastha Randhawa1Yu Shia Lin2Correspondence to: Maimonides Medical Center, 4802 10th avenue, Brooklyn, NY 11219, USA.; Maimonides Medical Center, Brooklyn, NY, USAMaimonides Medical Center, Brooklyn, NY, USAMaimonides Medical Center, Brooklyn, NY, USAAn 85-year-old woman with a history of total knee replacements for osteoarthritis in the past, presented with left knee swelling and pain that persisted for 14 months. An initial diagnosis of synovial cyst was made, and she underwent multiple aspirations and symptomatic treatments without improvement. Repeat arthrocentesis showed a WBC of 56,000/μL with 61 % neutrophils and 34 % lymphocytes. Synovial fluid bacterial and fungal cultures were negative. The acid-fast bacilli (AFB) culture revealed the Mycobacterium tuberculosis complex and was confirmed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) Mass Spectrometry. This case highlights the challenges of diagnosing tuberculous prosthetic joint infection in an elderly individual with knee pain.http://www.sciencedirect.com/science/article/pii/S2214250924002105Mycobacterium tuberculosisProsthetic joint
spellingShingle Asbah Rahman
Aastha Randhawa
Yu Shia Lin
Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges
IDCases
Mycobacterium tuberculosis
Prosthetic joint
title Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges
title_full Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges
title_fullStr Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges
title_full_unstemmed Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges
title_short Unmasking tuberculous arthritis in a prosthetic joint: Diagnostic and therapeutic challenges
title_sort unmasking tuberculous arthritis in a prosthetic joint diagnostic and therapeutic challenges
topic Mycobacterium tuberculosis
Prosthetic joint
url http://www.sciencedirect.com/science/article/pii/S2214250924002105
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