RESUMO
A 71-year-old man presented with septic arthritis of the hip with an initial culture growth of methicillin-sensitive Staphylococcus aureus (MSSA) masking the diagnosis of tuberculosis (TB). Based on joint aspirate culture and sensitivity results, the patient was first diagnosed with MSSA arthritis. He was started on intravenous antibiotics and underwent washout and debridement of hip. During the procedure, the surgeons observed characteristic tubercular changes and samples were sent for tubercular testing. The reports of cultures for acid-fast bacilli and synovial biopsies confirmed our intraoperative suspicion of TB. Antitubercular medication was started and it helped patient to improve quickly. He completed 9 months of tubercular treatment regimen and at completion total hip replacement was offered. At 8-year follow-up, the patient was doing fine with no recurrence of infection in his hip. High index of suspicion for skeletal TB was raised based on clinical and radiological signs especially if there was a delay or absence of response to appropriate therapy.
Assuntos
Antituberculosos/uso terapêutico , Artrite Infecciosa/diagnóstico , Infecções Estafilocócicas/diagnóstico , Tuberculose Osteoarticular/diagnóstico , Idoso , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/cirurgia , Artroplastia de Quadril/métodos , Desbridamento/métodos , Diagnóstico Diferencial , Articulação do Quadril/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Tomografia Computadorizada por Raios X , Tuberculose Osteoarticular/tratamento farmacológico , Tuberculose Osteoarticular/cirurgiaRESUMO
Prosthetic joint infection due to Salmonella spp is rare. Here we report an acute case of Salmonella enteritidis infection of a total hip arthroplasty in a man taking immunosuppressant medication. He was managed with antibiotics and two-stage revision surgery.