Prosthetic joint infections due to Mycobacterium tuberculosis: A report of 5 cases.

Introduction: Tubercular infection of prosthetic joint arthroplasty is sporadically described, but its incidence is rising. Misdiagnosis is common because of disparate clinical presentation.

Presentation Of Case: We describe 1 hand, 2 hip and 2 knee prosthetic-joint infections due to Mycobacterium tuberculosis in patients without a previous history of tuberculosis. All of them were initially misdiagnosed as bacterial infections and unsuccessfully treated with antibiotic for a long period of time. Diagnosis was made by means of culture of periprosthetic tissues and histolopathological examination. Tuberculosis was cured in all patients, but two of them have had a permanent functional damage (one arthrodesis of the knee and one loss of hand function).

Discussion: An aggressive diagnostic approach is required to make diagnosis of periprosthetic tubercular infection. The identification of the pathogen is advisable to test drug susceptibility.

Conclusion: The low index of suspicion of periprosthetic tubercular infection could delay a correct diagnosis with risk of permanent damage due to a late treatment. During any surgical revision of prosthetic joints with suspect infection culture for tuberculosis should be taken into consideration.