A Case of Triple Arthritis: Tuberculosis, MRSA and Gout in One Knee
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2015, Vol 8, Issue 8
Abstract
Aim: To report a case of concurrent tuberculous and bacterial arthritis in chronic tophaceous gout. Presentation of the Case: A 59-year old Filipino male patient consulted for sensorial changes with four-month progressive swelling of the right knee draining non-foul smelling yellowish discharge with chalky material. He eventually had arthrocentesis of right knee. Blood cultures were all negative. Acid fast bacilli were present both in the synovial fluid and endotracheal aspirate. Endotracheal aspirate grew Mycobacterium tuberculosis. Synovial fluid grew methicillin-resistant Staphylococcus aureus (MRSA). He was treated with prednisone, clindamycin, colchicine, febuxostat, tramadol, and anti-tuberculous medications. He failed to undergo surgery. Patient eventually had fatal myocardial infarction. Discussion: To our knowledge, this is the first report of concurrent tuberculous and bacterial (MRSA) arthritis in gout. Conclusion: This case highlights the possible differential diagnoses especially infections among patients with chronic tophaceous gout. Concurrent tuberculosis and bacterial arthritis can complicate the management of these patients. Hence, microbiologic and crystal analysis of synovial fluid is a very important part of the work-up to tailor the early, specific treatment for these patients.
Authors and Affiliations
Joey Tabula, Maricar Josephine Angeles, Agnes Mejia
Keywords
Related Articles
- EP ID EP347487
- DOI 10.9734/BJMMR/2015/17652
- Views 89
- Downloads 0
Preliminary Investigation Associated with Antibacterial Potency of Both Juice Extract and an Isolate from Aloe vera Gel
Objective: The aim of this study was to investigate the antibacterial activity of both the juice extract and an isolate of Aloe vera leaves of gel from Ghana on clinical isolate bacteria found to prolong wound infections...
Interrelation of Argyrophilic Proteins of Nucleolar Organizer Regions and Ki-67 with Clinical and Morphological Parameters and Survival in Patients with Non-small Cell Lung Cancer
Argyrophilic proteins associated with nucleolar organizer regions (AgNOR) and Ki-67 were studied at non-small cell lung cancer (NSCLC). Tumors with low and high area index (AI) of AgNOR and label index (LI) Ki-67 were de...
Papillary Thyroid Cancer: A Histopathological Review in Accra, Ghana
There is paucity of information on papillary thyroid cancer (PTC) in Ghana. The aim of this study was to determine the relative proportions of thyroid malignancies diagnosed in our institution that were PTC, the trend an...
The Effect of Breast Feeding on Eruption of First Primary Tooth in a Group of 6-12 Month Saudi Children
Eruption of primary teeth is a very important indicator to assess growth and development of the children. Aim: The present research studied the possible influence of the breast feeding on eruption time of first primary...
Kissing Abscess Type Infective Endocarditis Caused by Streptococcus tigurinus: A Case Report
Streptococcus tigurinus is associated with infective endocarditis and meningitis. Due to its similarity to other species it has been underreported. We report the case of a 46 years old patient with 3 months of intermitte...