2021
DOI: 10.1093/ofid/ofab451
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Management of Mycobacterium tuberculosis Prosthetic Joint Infection: 2 Cases and Literature Review

Abstract: Prosthetic joint infection caused by Mycobacterium tuberculosis (TBPJI) is uncommon but can be encountered in immunocompromised patients or those from tuberculosis endemic regions. A lack of clinical suspicion and experience with TBPJI often leads to a delay in diagnosis. We report 2 cases of TBPJI in a Hungarian-Canadian and Iranian-Canadian immigrant, respectively. Both were treated with concurrent surgical and medical therapy. We also performed a literature review on TBPJI case reports outlining their diagn… Show more

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Cited by 7 publications
(3 citation statements)
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“…However, in extrapulmonary infections, including bone and joint, culture sensitivity varies widely, ranging from 20% to 80% [ 24 ]. Due to the paucibacillary nature of MTB complex disease in PJI, culture sensitivity is reduced to approximately 60%-75%, with greater detection from synovial biopsies than synovial fluid aspiration [ 26 ]. In addition, co-existing bacterial infection may interfere with or obscure growth of MTB complex in culture, and as such, negative culture results do not rule out a diagnosis of MTB complex PJI.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…However, in extrapulmonary infections, including bone and joint, culture sensitivity varies widely, ranging from 20% to 80% [ 24 ]. Due to the paucibacillary nature of MTB complex disease in PJI, culture sensitivity is reduced to approximately 60%-75%, with greater detection from synovial biopsies than synovial fluid aspiration [ 26 ]. In addition, co-existing bacterial infection may interfere with or obscure growth of MTB complex in culture, and as such, negative culture results do not rule out a diagnosis of MTB complex PJI.…”
Section: Discussionmentioning
confidence: 99%
“…Nucleic acid amplification testing (NAAT) has proven to be highly effective in detecting extrapulmonary MTB complex infections, with higher sensitivity compared to culture-based diagnostics [ [26] , [27] , [28] , [29] ]. The Xpert MTB/RIF assay has revolutionized tuberculosis diagnostics with rapid detection of MTB complex and the rpoB gene mutation that predicts rifampin resistance.…”
Section: Discussionmentioning
confidence: 99%
“…Among patients with PJI, mycobacterial cultures should only be sent in select circumstances, such as patients receiving immunosuppressive therapy and those with CNPJI or failure to respond to antibacterial therapy [ 3 , 4 , 10 , 11 ]. In addition, patients with PJI and epidemiologic risk factors for tuberculosis should have specimens sent for mycobacterial culture [ 12 ]. A history of trauma, corticosteroid injection, and certain environmental exposures (example: hot tub exposures or gardening) may be considered as risk factors for mycobacterial infection.…”
Section: Discussionmentioning
confidence: 99%