Tuberculous and Nontuberculous Mycobacterial Infections
Skeletal tuberculosis (TB) refers to TB affecting the bones and/or joints. It is a rare disease and seen in 1–3% of patients with tuberculosis. There has been a surge in numbers partly driven by the HIV/AIDS epidemic. Musculoskeletal TB can manifest in the following forms—spondylitis (Pott’s disease), arthritis, and osteomyelitis. About half of these cases affect the spine, and the rest are extraspinal osteoarticular joints. Skeletal TB usually is a result of reactivation of bacilli lodged in the bones during the original seeding of the primary infection. Diagnosis of skeletal tuberculosis (TB) is a challenge especially considering that in more than half the cases there is no evidence of active chest disease. The indolent nature of the disease also contributes to its delays. Clues from history including prior TB contact, the systemic B-symptoms of TB, and countries of origin of the patient can help raise the level of suspicion for TB. The mainstay treatment of tuberculosis arthritis is appropriate anti-TB drug therapy.
KeywordsTuberculosis Musculoskeletal tuberculosis TB arthritis Poncet’s disease Pott’s disease Nontuberculous mycobacterial infections
- 6.Netval M, Hudec T, Hach J. [Our experience with total knee arthroplasty following tuberculous arthritis (1980-2005)]. Acta Chir Orthop Traumatol Cechoslov. 2007;74:111–3.Google Scholar
- 7.World Health Organization. Global tuberculosis report 2017. Available at: http://www.who.int/tb/publications/global_report/en/. Accessed on 03 Nov 2017.
- 16.Jarzembowski JA, Young MB. Nontuberculous mycobacterial infections. Arch Pathol. 2008;132:1330–4.Google Scholar
- 17.Tuli SM. Tuberculosis of the skeletal system. New Delhi: Jaypee Brothers Medical Publishers; 2016.Google Scholar
- 27.Diagnostic Standards and Classification of Tuberculosis in Adults and Children. This official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS Board of Directors, July 1999. This statement was endorsed by the Council of the Infectious Disease Society of America, September 1999. Am J Respir Crit Care Med. 2000;161:1376.CrossRefGoogle Scholar
- 41.Upadhyay SS, Sell P, Saji MJ, et al. Surgical management of spinal tuberculosis in adults. Hong Kong operation compared with debridement surgery for short and long term outcome of deformity. Clin Orthop Relat Res. 1994;(302):173.Google Scholar
- 45.Brown-Elliot B. Infections due to nontuberculous mycobacteria other than Mycobacterium avium intracellulare. In: EnMandell L, Bennet JE, Dolin R, editors. Principles and practice of infectious diseases. 7th ed. Philadelphia: Churching Livingstone-Elsevier; 2010. p. 3191–8.Google Scholar