Document Detail


Tuberculous arthritis--a fourteen-year experience at a tertiary teaching hospital in Taiwan.
MedLine Citation:
PMID:  18087629     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: To characterize the clinical and microbiological features of tuberculous arthritis and to clarify the factors affecting treatment outcome. METHODS: We retrospectively reviewed 51 adult patients with a diagnosis of tuberculous arthritis at Chang Gung Memorial Hospital-Linkou over a 14-year period. RESULTS: There were 35 males and 16 females with a mean age of 58.9 years (range, 32 to 89 years). The mean duration of symptoms and signs before diagnosis was 25.4 months (range, 0.25 to 180 months). Joint pain (96.1%) and swelling (90.2%) were two major presentations. Forty five (88.2%) patients had monoarthritis. Knee (26.7%) was the most frequently involved one. Twenty six (51.0%) patients had roentgenologic evidence of pulmonary tuberculosis (TB). Forty three patients (84.3%) had positive TB culture of synovial fluid and/or tissue. Of which, 27 (63%) had positive acid-fast bacillus smear. Twenty five patients had sputum for mycobacterial smear and culture, and 17 of them had positive TB culture. Thirty six patients received post-treatment follow-up for 3 to 110 months. Among them, 8 had relapses and 28 had treatment success. Compared the relapse to the success, the former had a higher ratio of drug resistant strains (odds ratio, 7.8; 95% confidence interval, 1.025-59.337; p=0.047) and had a longer treatment duration (22.0 +/- 4.4 vs 13.2 +/- 4.1 months; p=0.001). CONCLUSIONS: Tuberculous arthritis often occurred in elderly people with male predominance. Drug resistant strain may cause a relapse of tuberculous arthritis, which may result in longer treatment duration. Routine chest X-ray and sputum for mycobacterial smear and culture could be necessary to find concurrent pulmonary TB.
Authors:
Tsung-Yu Huang; Ting-Shu Wu; Chien-Chang Yang; Ping-Cherng Chiang; Kuang-Hui Yu; Ming-Hsun Lee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi     Volume:  40     ISSN:  1684-1182     ISO Abbreviation:  J Microbiol Immunol Infect     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-18     Completed Date:  2008-05-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100956211     Medline TA:  J Microbiol Immunol Infect     Country:  China    
Other Details:
Languages:  eng     Pagination:  493-9     Citation Subset:  IM    
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Arthritis, Infectious / diagnosis*,  epidemiology,  therapy
Drug Resistance, Bacterial
Female
Hospitals, Teaching
Humans
Male
Middle Aged
Recurrence
Retrospective Studies
Risk Factors
Taiwan / epidemiology
Treatment Outcome
Tuberculosis, Osteoarticular / diagnosis*,  epidemiology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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