Incision Infection With Mycobacterium tuberculosis After Total Hip Arthroplasty Without Any Primary Tuberculosis Focus

Abstract We describe a case of a tuberculous abscess unassociated with other clinical features of tuberculosis in a 46-year-old woman with a history of 4 hip surgeries plus total hip arthroplasty (THA) due to developmental hip dislocation. Four months after THA, she developed a collection at the inc...

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Bibliographic Details
Published in:The Journal of arthroplasty 2011-04, Vol.26 (3), p.505.e1-505.e3
Main Authors: Cansü, Eren, MD, Erdogan, Fahri, MD, Ulusam, Ayse Ovül, MD
Format: Article
Language:English
Subjects:
abscess
Arthroplasty, Replacement, Hip - adverse effects
Arthroplasty, Replacement, Hip - instrumentation
Arthroplasty, Replacement, Hip - methods
Drug Therapy, Combination
Ethambutol - therapeutic use
Female
Hip Dislocation, Congenital - surgery
Hip Prosthesis - adverse effects
Hip Prosthesis - microbiology
Humans
incision infection
Isoniazid - therapeutic use
Middle Aged
Mycobacterium tuberculosis
Mycobacterium tuberculosis - isolation & purification
Orthopedics
Prosthesis-Related Infections - diagnosis
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - etiology
Pyrazinamide - therapeutic use
Rifampin - therapeutic use
total hip arthroplasty
Treatment Outcome
tuberculosis
Tuberculosis - diagnosis
Tuberculosis - drug therapy
Tuberculosis - etiology
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Description
Summary:Abstract We describe a case of a tuberculous abscess unassociated with other clinical features of tuberculosis in a 46-year-old woman with a history of 4 hip surgeries plus total hip arthroplasty (THA) due to developmental hip dislocation. Four months after THA, she developed a collection at the incision site for which specimens produced positive culture findings for Mycobacterium tuberculosis . We could not detect any primary focus of tuberculosis anywhere in the patient's body. We performed soft-tissue debridement and drainage completely above the fascia lata to remove pus. The infection recurred twice despite chemotherapy and the earlier treatment. At a 6-year follow-up examination, there was no sign of either tuberculosis or prosthetic loosening. To our knowledge, this is the first report of localized tuberculous abscess within a THA incision.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2009.11.025