Tuberculosis of the Trochanteric Bursa: A Case Report

Kim, Seong-Tae; Moon, Myung-Sang; Yoon, Min-Geun; Park, Woosung; Heo, Jee-Hyun

doi:10.1177/230949901402200131

Cited by 5 publications

(8 citation statements)

References 12 publications

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“…4 Tuberculous bursitis most frequently occurs in the hip. 6 As already mentioned, TTB is a rare entity, especially in immunocompetent patients. Typically, TTB arises from the reactivation of an unknown primary infection.…”

Section: Discussionmentioning

confidence: 96%

Tuberculous trochanteric bursitis in an immunocompetent patient

Costa,

Lages,

Negrão

et al. 2023

IPMRJ

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Musculoskeletal Tuberculosis occurs in 1%–3% of patients with tuberculosis, and Tuberculous trochanteric bursitis (TTB) is responsible for 1%, assuming it as a rare clinical condition, especially if it occurs in immunocompetent patients. This is a case report about a 51 years old man, with pain in right trochanteric area, without swelling or inflammatory signs, 1 year of evolution. About 20 years ago, he suffered an infected traumatic local hematoma. Ultrasound revealed trochanteric bursitis. He was then submitted to a bursectomy. Histological study revealed chronic necrotizing granulomatous bursitis, with negative Acid-Fast Bacillus (AFB) Tests. After 6 mouths the patient suffer relapse of his complains. The MRI revealed intraosseous edema of the great right trochanter, inflammation of adjacent soft tissues and small infratrochanteric collection. Analytically, CRP of 1.24 mg/dl and positive interferon Gamma. A new bursectomy and curettage were performed with sequestrectomy. Lowestein culture was positive for AFB, it was identified protein MPT64, and a positive DNA Mycobacterium tuberculosis complex research. It was associated medical treatment with antibiotics (12 months). Currently with clinical and imaging improvement, without relapse, after 1 and a half years of follow-up. Usually, TTB arises from the reactivation of an unknown primary infection, whose clinical presentation is often vague, characterized by chronic symptoms. This condition should be considered in the diagnostic discussion whenever a case of recurrent bursitis arises despite the treatment instituted. With the decline in the incidence of tuberculosis, the number of clinical cases of TTB described in the recent literature has decreased considerably, with special attention being given to the reporting and sharing of these cases, with the goal of keeping this diagnosis in perspective in the discussion and orientation of cases of trochanteric bursitis.

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Section: Discussionmentioning

confidence: 96%

Tuberculous trochanteric bursitis in an immunocompetent patient

Costa,

Lages,

Negrão

et al. 2023

IPMRJ

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“…Pour réduire le risque de diffusion mycobacérienne chez les personnes avec atteinte du trochanter, une antibiothérapie antituberculeuse doit être lancée immédiatement une fois le diagnostic définitif est confirmé [ 11 ]. Cette thérapie anti bacillaire seule peut éradiquer la maladie à tout moment de l’évolution et sa durée est de 12 mois, la chirurgie est indiquée en présence de complications [ 12 ], elle permet accélérer la guérison des cas évolués et d'eviter les récidives [ 13 ]. Une Réactivation de la maladie après thérapie anti bacillaire associée ou non à un traitement chirurgical a été reportée.…”

Section: Discussionunclassified

La trochantérite tuberculeuse, un diagnostic souvent difficile

Mhammdi¹,

Boufettal²,

Kharmaz³

et al. 2016

Pan Afr Med J

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La trochantérite tuberculeuse est une affection rare (<2% des tuberculoses ostéo-articulaires), même en pays à forte endémie, elle est caractérisée par une symptomatologie insidieuse rendant souvent son diagnostic tardif. Les auteurs rapportent une série de 9 cas, le diagnostic a été posé sur des études bactériologiques et histologiques après un bilan d'imagerie (échographie, IRM, TDM). Le traitement de cette affection est médical (antibiothérapie antituberculeuse), et la chirurgie ne trouve sa place qu'en cas de complications et permet d'améliorer l’évolution.

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“…The source of infection of tuberculous bursitis in our patient remains unclear, as there was no evidence of hematogenous dissemination or local involvement due to proximity. Symptoms of tuberculous bursitis are usually mild and occur insidiously, delaying diagnosis and treatment 3 . There is mild pain and swelling on the lateral aspect of the hip overlying the greater trochanter with or without limp and minimal limitation in functional activities.…”

Section: Case Detailsmentioning

confidence: 99%

“…Tuberculosis of soft tissue can rarely affect muscle 1 , synovial sheath of tendons 2 , fascia 1 and bursa, accounting for about 1% of musculoskeletal tuberculosis 3 . Tuberculous trochanteric bursitis is rare 3-5 .…”

Section: Introduction ᴪmentioning

confidence: 99%