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Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review

INTRODUCTION: Tuberculosis (TB) of pubic symphysis is an extremely uncommon condition accounting <1% of all musculoskeletal TB. Further recurrence of TB of symphysis pubis is a rare clinical scenario requiring a high level of suspicion for diagnosing the condition. Recurrence of tuberculosis can...

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Autores principales: Kumar, Rajnand, Kumar, Nitish, Bharti, Ajay, Kushwaha, Sudhir Shyam, Kumar, Vivek, Choudhary, Milind Chandra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10599378/
https://www.ncbi.nlm.nih.gov/pubmed/37885625
http://dx.doi.org/10.13107/jocr.2023.v13.i10.3976
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author Kumar, Rajnand
Kumar, Nitish
Bharti, Ajay
Kushwaha, Sudhir Shyam
Kumar, Vivek
Choudhary, Milind Chandra
author_facet Kumar, Rajnand
Kumar, Nitish
Bharti, Ajay
Kushwaha, Sudhir Shyam
Kumar, Vivek
Choudhary, Milind Chandra
author_sort Kumar, Rajnand
collection PubMed
description INTRODUCTION: Tuberculosis (TB) of pubic symphysis is an extremely uncommon condition accounting <1% of all musculoskeletal TB. Further recurrence of TB of symphysis pubis is a rare clinical scenario requiring a high level of suspicion for diagnosing the condition. Recurrence of tuberculosis can occur either be due to relapse of the original infection or reinfection due to exogenous Mycobacterium tuberculosis strain. There have only been nine case reports on TB of the pubic symphysis in the last three decades and only 40 patients were identified in English language medical literature so to the best of our knowledge this is the first case report on the recurrence of TB of pubic symphysis. CASE REPORT: A 26-year-old female patient presented with pain over symphyseal area for 2 months. Laboratory and radiological investigations were suggestive of TB of symphysis pubis. She was started on oral, category I anti-tubercular therapy (ATT) from DOTS center. Patient on improvement in symptoms discontinued taking ATT after 6 months. About 7 months after stopping ATT, she again presented with pain over symphyseal area and difficulty in walking. Laboratory, radiological investigation, and biopsy were obtained to rule out multidrug-resistant (MDR) TB. The patient improved on 12 months’ oral daily ATT regime (HRZES2+HRZE4+HRE6). She was followed up for another 1 year with clinical examination and laboratory investigation after stopping ATT. At present, she is asymptomatic with no signs of recurrence after 1 year of completion of treatment. CONCLUSION: ATT intake should be continued for 12 months for musculoskeletal TB for preventing recurrence. The biopsy needs to be taken from the affected region in recurrence TB to rule out MDR.
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spelling pubmed-105993782023-10-26 Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review Kumar, Rajnand Kumar, Nitish Bharti, Ajay Kushwaha, Sudhir Shyam Kumar, Vivek Choudhary, Milind Chandra J Orthop Case Rep Case Report INTRODUCTION: Tuberculosis (TB) of pubic symphysis is an extremely uncommon condition accounting <1% of all musculoskeletal TB. Further recurrence of TB of symphysis pubis is a rare clinical scenario requiring a high level of suspicion for diagnosing the condition. Recurrence of tuberculosis can occur either be due to relapse of the original infection or reinfection due to exogenous Mycobacterium tuberculosis strain. There have only been nine case reports on TB of the pubic symphysis in the last three decades and only 40 patients were identified in English language medical literature so to the best of our knowledge this is the first case report on the recurrence of TB of pubic symphysis. CASE REPORT: A 26-year-old female patient presented with pain over symphyseal area for 2 months. Laboratory and radiological investigations were suggestive of TB of symphysis pubis. She was started on oral, category I anti-tubercular therapy (ATT) from DOTS center. Patient on improvement in symptoms discontinued taking ATT after 6 months. About 7 months after stopping ATT, she again presented with pain over symphyseal area and difficulty in walking. Laboratory, radiological investigation, and biopsy were obtained to rule out multidrug-resistant (MDR) TB. The patient improved on 12 months’ oral daily ATT regime (HRZES2+HRZE4+HRE6). She was followed up for another 1 year with clinical examination and laboratory investigation after stopping ATT. At present, she is asymptomatic with no signs of recurrence after 1 year of completion of treatment. CONCLUSION: ATT intake should be continued for 12 months for musculoskeletal TB for preventing recurrence. The biopsy needs to be taken from the affected region in recurrence TB to rule out MDR. Indian Orthopaedic Research Group 2023-10 2023-10 /pmc/articles/PMC10599378/ /pubmed/37885625 http://dx.doi.org/10.13107/jocr.2023.v13.i10.3976 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Unported, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms
spellingShingle Case Report
Kumar, Rajnand
Kumar, Nitish
Bharti, Ajay
Kushwaha, Sudhir Shyam
Kumar, Vivek
Choudhary, Milind Chandra
Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review
title Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review
title_full Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review
title_fullStr Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review
title_full_unstemmed Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review
title_short Pubic Symphysis Tuberculosis Recurrence - A Rare Case Report and Literature Review
title_sort pubic symphysis tuberculosis recurrence - a rare case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10599378/
https://www.ncbi.nlm.nih.gov/pubmed/37885625
http://dx.doi.org/10.13107/jocr.2023.v13.i10.3976
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