Case Report

Mycobacterium Tuberculosis Infection of a Presumed Charcot Joint

Authors: Jason F. Okulicz, MD, Bradley A. Lloyd, MD, John O. Krause, MD, Nicholas G. Conger, MD

Abstract

A 65-year-old male with peripheral neuropathy and small lymphocytic lymphoma presented with erythema and edema of the left foot. A Charcot midfoot was diagnosed and treated with a total contact cast and restricted weight bearing. However, subsequent analysis of bone and synovial fluid months later revealed Mycobacterium tuberculosis infection.


Key Points


* Bone and joint tuberculosis is uncommon in the United States; however, the human immunodeficiency virus epidemic and the increasing use of drugs that alter cell-mediated immunity may lead to increased incidence.


* The diagnosis of bone and joint tuberculosis is often delayed because of the mimicry of other syndromes (such as Charcot joint) and may be facilitated by the precipitation of an acute gout attack.


* Early diagnosis is aided by a high degree of clinical suspicion, and prolonged medical treatment is necessary to prevent joint deformity.

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