Artritis tuberculosa de tobillo, a propósito de un caso

Abstract

Introduction

The Tuberculosis (TBC) annual report of the World Health Organization (WHO) during the year 2021 reports 9.9 million new cases and 1.3 million of deaths attributable to the disease. Osteoarticular extra pulmonary involvement corresponds to 1-3% of cases; 50% correspond to the spine and the minority to small joints.

Case report

We present the case of a 21-year-old patient who is seen in clinic for pain and functional limitation of the ankle that started 14 months prior. The patient had no respiratory symptoms. After 18 months, and with reactivation of pulmonary symptoms, a diagnosis of septic arthritis due to tuberculosis was confirmed with culture and real-time polymerase chain reaction (PCR).

Results

Due to chronic septic arthritis, the patient presents severe and irreversible joint damage of the ankle. There are no episodes of relapse or recurrence of joint infection after 2 years of follow-up.

Discussion

The extra pulmonary presentation of tuberculosis infection is infrequent, especially in small joints. It is important to consider differential diagnoses when managing it. Chronic septic arthritis due to TBC can mimic any other type of disease, hence, microbiological diagnostic aids must be available. An analysis of the case is done in parallel with the literature.

Level of evidence: V