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Extrapulmonary Tuberculosis pp 71–82Cite as

Tuberculosis Arthritis and Osteomyelitis

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Abstract

Although musculoskeletal tuberculosis (TB) is a rare extrapulmonary complication of Mycobacterium tuberculosis, it is still a problem in developing countries. TB infection in bone and joint is a secondary infection, mostly hematogenous spread to the bone and joints and more rarely disseminated through another focus such as kidney or lymph nodes. In adults, tuberculous osteoarthritis usually presents as a single lesion; in children, older adults, and immunocompromised persons, including those with HIV infection, the lesions may be multiple. Patients with widespread lesions may be misdiagnosed as having a malignant process, or bacterial superinfection can also mask the diagnosis and presentation. Culture is the gold standard for diagnosis, but generally it is possible with examinated biopsy or aspiration specimen or sinus tract specimen by AFB smear, polymerase chain reaction (PCR), and histopathologic method. Clinical evaluation is very important for management and treatment. There is no definitive recommendation for treatment. According to the clinical feature, some patients may require surgical treatment as well as antituberculosis treatment. The basic principles are applied for extrapulmonary disease (Sharma and Mohan, Indian J Med Res 120:316–353, 2004). Two months of isoniazid (INH) and rifampicin (RIF), pyrazinamide (PZA), and ethambutol (EMB) followed by 7–10 months of INH and RIF are recommended as initial therapy unless the organisms are known or strongly suspected resistant TB to the first-line drugs.

In this section, tuberculous arthritis and osteomyelitis are presented with epidemiology, clinical feature and diagnosis, management, and treatment.

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Author information

Authors and Affiliations

  1. Mersin University, Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Mersin, Turkey

    Gülden Ersöz

  2. Health Science University, Antalya Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Antalya, Turkey

    Nefise Öztoprak & Figen Sarıgül

Authors
  1. Gülden Ersöz
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  2. Nefise Öztoprak
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  3. Figen Sarıgül
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Editors and Affiliations

  1. Department of Infectious Disease & Clinical Microbiology, Onsekiz Mart University, Canakkale, Turkey

    Alper Sener

  2. ID-IRI Lead Coordinator, Department of Infectious Disease & Clinical Microbiology, Ankara, Turkey

    Hakan Erdem

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Ersöz, G., Öztoprak, N., Sarıgül, F. (2019). Tuberculosis Arthritis and Osteomyelitis. In: Sener, A., Erdem, H. (eds) Extrapulmonary Tuberculosis. Springer, Cham. https://doi.org/10.1007/978-3-030-04744-3_6

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