- MeSH
- infekční artritida diagnóza etiologie patologie terapie MeSH
- infekční nemoci kostí diagnóza etiologie patofyziologie terapie MeSH
- lidé MeSH
- muskuloskeletální nemoci * diagnóza etiologie patologie terapie MeSH
- nemoci kloubů diagnóza etiologie terapie MeSH
- ortopedické výkony MeSH
- osteomyelitida diagnóza etiologie terapie MeSH
- tuberkulóza osteoartikulární diagnóza etiologie patologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Tuberkulóza (TB) je onemocnění způsobené skupinou bakterií označovanou jako M. tuberculosis complex. Tuberkulóza u dětí postihuje nejčastěji plíce (až v 80 % případů), může však postihnout i další orgány (mimoplicní forma tuberkulózy). Česká republika představuje zemi s nízkou incidencí tuberkulózy (méně než 5 případů na 100 000 obyvatel),(1) i přesto se u nás vyskytují vzácné a závažné formy plicní i mimoplicní. Představujeme kazuistiku roční dívky s plicní a kombinovanou mimoplicní formou tuberkulózy (konkrétně postižení páteře a mozku). Pacientka byla pro přetrvávání zastínění na skiagramu hrudníku podrobena dalšímu vyšetřovacímu procesu, který potvrdil diagnózu plicní tuberkulózy. Překvapivým vedlejším nálezem byla hrudní spondylitida s abscesem a nález tuberkulomů v CNS. Antituberkulózní léčbou, spondylochirurgickou operací a multioborovou spoluprací bylo dosaženo zlepšení klinického stavu.
Tuberculosis (TB) is a disease caused by a group of bacteria, collectively named the M. tuberculosis complex. In most cases, tuberculosis in children affects the lungs (80%) but can affect any other organ (extrapulmonary tuberculosis). Although the Czech Republic is a country with a low incidence of tuberculosis (< 5 cases per 100 000 population per year),(1) severe and rare forms of extrapulmonary tuberculosis occur. This case report presents a one-year-old girl with coincident pulmonary and two extrapulmonary forms of tuberculosis (spine and brain). The patient due to persistent X-ray opacification underwent other diagnostic examinations verifying lung tuberculosis. The surprising finding was thoracic spondylitis with abscess and tuberculomas in the CNS. We achieved good clinical progresswith antituberculosis treatment, spine surgery intervention, and a multidisciplinary approach.
- Klíčová slova
- mimoplicní tuberkulóza,
- MeSH
- diagnostické zobrazování metody MeSH
- kojenec MeSH
- lidé MeSH
- tuberkulóza osteoartikulární diagnóza terapie MeSH
- tuberkulóza páteře diagnóza terapie MeSH
- tuberkulóza * diagnóza komplikace terapie MeSH
- výsledek terapie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Tuberculosis (TB) is still a worldwide problem. We present a case of flexor tenosynovitis due to tuberculosis in the hand and wrist. A 42-year-old man presented to the outpatient clinic with a 2-year history of a slowly growing mass over the volar aspect of the left wrist. His MRI showed multiple rice bodies in the wrist and hand. An open biopsy was performed. Pathology specimens showed granulomatous lesions with central necrosis. The purified protein derivative (PPD) test was positive. In this case, granulomatous lesions with central necrosis, rice bodies, and positive PPD test confirmed the diagnosis of TB in the wrist and hand. There was no other concurrent evidence of TB elsewhere. Antituberculosis chemotherapy was commenced. Tuberculous tenosynovitis of the wrist and hand is very rare. The tuberculous tenosynovitis should be kept in mind as an infectious agent when patients are presenting with atypical clinical. Key words: tuberculosis, rice bodies, flexor tenosynovitis, wrist, hand.
- MeSH
- dospělí MeSH
- lidé MeSH
- ruka MeSH
- tenosynovitida * diagnóza MeSH
- tuberkulóza osteoartikulární * komplikace diagnóza farmakoterapie MeSH
- zápěstí MeSH
- zápěstní kloub diagnostické zobrazování MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
A child from a Roman necropolis in Pécs, Hungary (4th century CE) was initially diagnosed with severe spinal osteomyelitis. The post-cranial skeleton displayed bone alterations in the lower thoracic and upper lumbar segments, including vertebral body destruction, collapse and sharp kyphosis, and additional multiple rib lesions, suggesting a most likely diagnosis of pulmonary and spinal tuberculosis. This study discusses a number of selected diagnoses in the context of our pathological findings, complementing the macroscopic examination with radiological and biomolecular analyses.
- MeSH
- bederní obratle patologie MeSH
- dějiny starověku MeSH
- dítě MeSH
- hrudní obratle patologie MeSH
- lidé MeSH
- osteomyelitida diagnóza dějiny patologie MeSH
- paleopatologie * MeSH
- tuberkulóza osteoartikulární diagnóza dějiny patologie MeSH
- Check Tag
- dějiny starověku MeSH
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- historické články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Maďarsko MeSH
PURPOSE OF THE STUDY: Tuberculosis (TB) in a joint region presents high risk of damage to the joint. Consequences of a late diagnosis and inadequate therapy may be serious particularly in the large joints of lower extremities. Tuberculosis of knee and hip joints accounts for about 25% to 35% of osteoarticular tuberculosis (OAT). The aim of this study was to evaluate the objective and subjective results of tuberculosis treatment in knee and hip joints. MATERIAL AND METHODS: Of 258 OAT patients treated at the Specialised Treatment Centre Jevíčko between January 2005 and September 2012, tuberculosis of the hip joint was diagnosed in 31 patients in whom three hips were treated by incision and drainage and 10 by total hip replacement; 18 patients had tuberculosis of the knee joint with the following treatment: puncture in seven knees, incision and drainage in eight, excochleation of a tuberculous focus in the proximal tibia in two, removal of a bursa in one, arthrodesis in four and total knee replacement in four patients. The patients continued to be followed up at the Jevíčko Centre. The scale of 1 to 5 (best to worst) was established for evaluation of objective and subjective results of the treatment. The data were analysed using the basic statistical characteristics and compared. RESULTS: The objective evaluation was better for the hip joint; the sums of relative frequencies of marks 1 to 3 were 72.22% in the knee and 80.65% in the hip. In the knee more than 50% of the cases fell in the interval <1.304; 4.252>, in the hip this was <1.296; 3.672>. The hip joint was better subjectively evaluated, it had a higher sum of relative frequencies of marks 1 to 3, i.e., 96.77% as compared with 88.89% for the knee. In the knee more than 50% of the cases had marks in the interval <0.767; 3.122>; in the hip this was <0.869; 2.680>. The hip joint was better evaluated both objectively and subjectively. DISCUSSION: An early diagnosis allows for the treatment of synovitis, which has a better prognosis than an arthritic disease. The subjective perception of treatment results showed a better evaluation than its objective correlate. Many patients were satisfied with the results, even with an immobilised joint (in arthrodesis). Total joint replacement in OAT patients does not always provide expected results in either knee or hip joints. Arthrodesis also has its indications related to health condition, age and social status of the patient. In periprosthetic TB infections, a careful consideration should be given to removal of the prosthesis and its re-implantation in relation to all circumstances associated with each particular case. CONCLUSIONS: Tuberculosis of large weight-bearing joints is a rare entity in the countries with low TB prevalence, including the Czech Republic. It is necessary to pay attention to diagnosis and therapy and make them more effective even at higher costs associated with total hip replacement in TB or post-TB patients in order to maintain or restore joint function. At the time of borders open for citizens from countries with higher TB prevalence, the diagnosis of OAT should be considered.
- MeSH
- burzitida diagnóza epidemiologie MeSH
- časná diagnóza MeSH
- dospělí MeSH
- drenáž metody MeSH
- kolenní kloub * MeSH
- komorbidita MeSH
- kyčelní kloub MeSH
- lidé MeSH
- náhrada kyčelního kloubu MeSH
- prognóza MeSH
- rozsah kloubních pohybů MeSH
- tendinopatie diagnóza epidemiologie MeSH
- totální endoprotéza kolene MeSH
- tuberkulóza osteoartikulární diagnóza epidemiologie terapie MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- hodnotící studie MeSH
- MeSH
- antituberkulotika aplikace a dávkování MeSH
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Mycobacterium tuberculosis izolace a purifikace patogenita MeSH
- plicní tuberkulóza diagnóza farmakoterapie MeSH
- tuberkulóza osteoartikulární diagnóza farmakoterapie MeSH
- tuberkulóza diagnóza farmakoterapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
The paper presents updated epidemiological data on osteoarticular tuberculosis (OAT) among children and adolescents in Kazakhstan during 1995-2007. Retrospective analysis of methods of detection, risk factors for disease development and frequency of mistaken diagnosis among 248 children and adolescents was conducted. Our investigation revealed that during 2006-2007 decrease in OAT incidence was marked among children to 0.6 and adolescents to 0.9 per 100000 population. Phthisiatric methods allowed to verify the OAT diagnosis in 27±2.8% of cases, roengenological ones - in 69.4±2.9% (р<0.05), surgical biopsy method - in 17.9±2%; diagnosis of OAT was verified in 72.5±2.4% of cases at addressing of relatives of a patient.
- MeSH
- absces etiologie chirurgie MeSH
- antituberkulotika terapeutické užití MeSH
- bolesti zad MeSH
- diagnostické techniky a postupy MeSH
- dospělí MeSH
- emigranti a imigranti MeSH
- hmotnostní úbytek MeSH
- kašel MeSH
- lidé MeSH
- mediastinum chirurgie MeSH
- páteř chirurgie patologie MeSH
- počítačová rentgenová tomografie MeSH
- polymerázová řetězová reakce MeSH
- reoperace MeSH
- retroperitoneální prostor chirurgie MeSH
- spondylitida diagnóza chirurgie komplikace MeSH
- tuberkulóza miliární diagnóza komplikace radiografie MeSH
- tuberkulóza osteoartikulární diagnóza patofyziologie terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
TBC je specifické infekční onemocnění, které bylo vzhledem ke své zvláštnosti a závažnosti vždy sledováno odděleně od ostatních infekčních nemocí. Způsobují ji především mykobakterie. Hlavním cílovým orgánem jsou plíce, ale může postihovat i mimoplicní struktury.
Tuberculosis is a specific infectious disease, which has always been tracked separately from other infectious diseases. It is caused primarily by mycobacteria. The main target organs are the lungs, but it can also affect non-pulmonary structures.
