ABSTRACT
We describe a case of a tuberculous abscess unassociated with other clinical features of tuberculosis in a 46-year-old woman with a history of 4 hip surgeries plus total hip arthroplasty (THA) due to developmental hip dislocation. Four months after THA, she developed a collection at the incision site for which specimens produced positive culture findings for Mycobacterium tuberculosis. We could not detect any primary focus of tuberculosis anywhere in the patient's body. We performed soft-tissue debridement and drainage completely above the fascia lata to remove pus. The infection recurred twice despite chemotherapy and the earlier treatment. At a 6-year follow-up examination, there was no sign of either tuberculosis or prosthetic loosening. To our knowledge, this is the first report of localized tuberculous abscess within a THA incision.
Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Hip Prosthesis/adverse effects , Mycobacterium tuberculosis/isolation & purification , Prosthesis-Related Infections/diagnosis , Prosthesis-Related Infections/etiology , Tuberculosis/diagnosis , Tuberculosis/etiology , Arthroplasty, Replacement, Hip/instrumentation , Arthroplasty, Replacement, Hip/methods , Drug Therapy, Combination , Ethambutol/therapeutic use , Female , Hip Dislocation, Congenital/surgery , Hip Prosthesis/microbiology , Humans , Isoniazid/therapeutic use , Middle Aged , Prosthesis-Related Infections/drug therapy , Pyrazinamide/therapeutic use , Rifampin/therapeutic use , Treatment Outcome , Tuberculosis/drug therapyABSTRACT
OBJECTIVE: Atlantoaxial rotatory subluxation (AARS) is an uncommon lesion seen mainly in children and adolescents. A retrospective analysis of 12 patients with AARS treated non-operatively is presented in this study. MATERIAL AND METHODS: Twelve patients with AARS who were treated non-operatively were evaluated retrospectively in terms of recent trauma and respiratory tract infection history, accompanying injuries, radiological findings, duration of symptoms, amount and duration of traction and clinical results of the treatment. RESULTS: Traumatic AARS was present in 8 patients. No evidence of trauma was found in 4 patients. Type I subluxations in 10 and type II subluxations in 2 patients were found according to the Fielding and Hawkins classification. All patients were treated using bed-side mentooccipital tractions. The mean duration of bed-side mentooccipital traction was 3,75 days and the mean amount of load was 1.8 kg. All patients were kept in Philadelphia collars for additional 3 weeks after the clinical recovery. No limitations and pain in head movements were present in any patient at the sixth month follow-up examinations. CONCLUSION: Paediatric patients with neck pain and torticollis should be investigated concerning trauma and recent respiratory tract infection history in order to avoid any delay in diagnosis of a possible AARS.