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Prosthetic Joint Infection of the Knee Due to Mycobacterium tuberculosis

A Case Report and Review of the Literature

Al Soub, Hussam MD, CABM, FACP; Yacoub, Nada CABM, MRCP; Al Soub, Deema MD

Infectious Diseases in Clinical Practice: July 2019 - Volume 27 - Issue 4 - p 191–194
doi: 10.1097/IPC.0000000000000732
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Background Tuberculous prosthetic joint infection is a rare but serious complication of joint replacement surgery. We report a case of tuberculous prosthetic knee joint infection and review similar cases reported in the literature. The aims of this study were to alert physicians to this rare complication and review the experience of others to improve diagnosis and outcome of this serious complication.

Methods We report a case and review the literature of all published cases of tuberculous prosthetic knee joint infections in the period between 1950 and 2017.

Results We found 36 cases reported in the literature, which brings the total number of cases including ours to 37. Majority of cases were reported after the year 2000 and predominantly affecting elderly with a median age of 71 years. Clinical manifestations are nonspecific, with pain and swelling being the most common presenting symptoms (70.5% and 67.5%, respectively). Diagnosis was established by culture or histopathology, which were diagnostic in 89% and 39% of cases, respectively. Management requires the use of antituberculous medication and in some patients in addition surgery. In 35% of patients, medical therapy alone was successful. A 12-month duration of antituberculous drugs is adequate. The outcome is favorable, with survival in 89% of patients.

Conclusions Tuberculous infection of prosthetic knee joint is a rare but serious complication of total knee replacement surgery. Treatment with antituberculous drugs and surgery in some patients results in favorable outcome.

From the Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.

Correspondence to: Hussam Al Soub, MD, CABM, FACP, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. E-mail: hussamalsoub@yahoo.com.

The authors have no funding or conflicts of interest to disclose.

Online date: June 5, 2019

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