Chronic foot pain, an atypical tuberculosis presentation

Maignant, A.; Salvator, Hélène; Montigny, J. P.; Gonin, François; Mellot, François; Couderc, Louis Jean; Catherinot, Émilie

doi:10.1016/j.medmal.2019.05.003

Cited by 2 publications

(7 citation statements)

References 9 publications

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“…The radiographic features of osteoarticular TB are nonspecific and can be observed 2 to 5 months after the onset of clinical manifestations. 4 The most encountered radiographic finding is osteolytic lesion surrounded a condensed zone. Frequent associated features are osteopenia, subchondral erosion, and adjacent soft tissue swelling.…”

Section: Discussionmentioning

confidence: 99%

“…Tuberculous osteomyelitis is an uncommon form of extrapulmonary TB. Foot involvement is seldom seen and accounts for <0.01% of all TB cases 4. Choi et al3 studied 369 cases of osteoarticular TB of which only 15 cases (4.1%) involved the foot.…”

Section: Discussionmentioning

confidence: 99%

“…Literature suggests that the incidence of metatarsal TB osteomyelitis is <0.5% 8. TB osteomyelitis usually arises from foci of bacilli, lodged in the bone during the initial mycobacteremia, without a resulting infection in immunocompetent individuals 4. TB infection arises as a result of an immunocompromised state (Malnutrition, old age, HIV infection, Renal failure, hemodialysis, immunosuppressants, and long-term corticosteroid treatment).…”

Section: Discussionmentioning

confidence: 99%

“…8 TB osteomyelitis usually arises from foci of bacilli, lodged in the bone during the initial mycobacteremia, without a resulting infection in immunocompetent individuals. 4 TB infection arises as a result of an immunocompromised state (Malnutrition, old age, HIV infection, Renal failure, hemodialysis, immunosuppressants, and long-term corticosteroid treatment). As in our case, the patient was following a long course of immunosuppressive therapy for an autoimmune disease.…”

Section: Discussionmentioning

confidence: 99%

“…Foot involvement is seldom seen and accounts for <0.01% of all TB cases. 4 Choi et al 3 studied 369 cases of osteoarticular TB of which only 15 cases (4.1%) involved the foot. Maignant et al 4 reported 8 cases involving the foot localization of TB in 365 patients (2.2%).…”

Section: Discussionmentioning

confidence: 99%

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Tuberculous Osteomyelitis of the Fifth Metatarsal Treated Using the Induced Membrane Technique: A Case Report

Bellil

Tekaya

Souissi

et al. 2022

Techniques in Foot &Amp; Ankle Surgery

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Tuberculous osteomyelitis of the foot, an uncommon and rare entity, accounts for <0.01% of all tuberculous localizations. Osteomyelitis secondary to tuberculosis is difficult to diagnose and treat, requiring a high suspicion index. We report a case of tuberculous osteomyelitis of the fifth metatarsal bone treated with the induced membrane technique. Here, we report the case of a 40-year-old woman with a history of immunosuppressive treatment presented with a complaint of painful swelling of the left foot. Radiographs showed osteolytic lesions of the fifth metatarsal bone. Initial biopsy suggested tuberculosis. She was surgically treated with the induced membrane technique. Histology confirmed tuberculous osteomyelitis and antituberculous treatment was initiated. Full weight-bearing was allowed after 8 months. At 24 months follow-up, all symptoms were resolved. The radiographs showed an integrated graft. In conclusion, the presence of osteolytic lesions on a plain film should rise high suspicious for a possible infection requiring biopsy, and if confirmed, mandates surgical debridement and reconstruction. The induced membrane technique offers a mean to treat infectious bone defects.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Tuberculous Osteomyelitis of the Fifth Metatarsal Treated Using the Induced Membrane Technique: A Case Report

Bellil

Tekaya

Souissi

et al. 2022

Techniques in Foot &Amp; Ankle Surgery

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Clinical characteristics, treatment and efficacy of calcaneal osteomyelitis: a systematic review with synthesis analysis of 1118 reported cases

Jiang,

Chen,

Liu

et al. 2024

International Journal of Surgery

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Background: Calcaneal osteomyelitis (CO) still poses great challenges to orthopaedic surgeons due to unique anatomic and functional features of the calcaneus. This study summarized the current data regarding clinical characteristics, treatment and efficacy of CO, based on an analysis of literature-reported cases. Materials and Methods: We searched the PubMed, Embase, and Cochrane Library databases to find English and Chinese studies reporting on CO patients between 2000 and 2021, with available data for synthesis analysis. The quality of the included studies was evaluated by the National Institutes of Health (NIH) assessment scale. Effective data were extracted and pooled for analysis. Results: Altogether 198 studies involving 1118 patients were included, with a male-to-female ratio of 2.3 (724 males and 310 females). The median age at CO diagnosis was 46 years, with a median symptom duration of 3 months. Injury-related infections (524 cases) and diabetic foot infections (336 cases) were the two most common causes, with ulcer (468 cases) and wound sinus or exudation (209 cases) being the predominant symptoms. The overall positive culture rate was 80.2%, with polymicrobial infections accounting for 18.1%. Staphylococcus aureus was the most frequently detected pathogen (42.7%), with fungal-related infections isolated in 17 cases. Although most patients received surgical interventions (96.9%), the recurrence rate was 20.1%. The incidence of infection relapse following partial calcanectomy, total calcanectomy, debridement with implantation of local antibiotics, and debridement with or without flap or skin coverage were 31.7%, 45.0%, 16.8%, and 15.1%, respectively. The overall incidence of limb amputation was 12.4%, with all-cause and CO-related mortalities of 2.8% and 0.2%, separately. Conclusions: CO shared similar characteristics with extremity chronic osteomyelitis, primarily affecting young males, with trauma and diabetic foot as the leading causes and Staphylococcus aureus as the most frequently detected pathogen. Despite surgery being the primary treatment modality, clinical outcomes remained unsatisfactory, marked by high rates of infection recurrence and limb amputation.

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Chronic foot pain, an atypical tuberculosis presentation

Cited by 2 publications

References 9 publications

Tuberculous Osteomyelitis of the Fifth Metatarsal Treated Using the Induced Membrane Technique: A Case Report

Tuberculous Osteomyelitis of the Fifth Metatarsal Treated Using the Induced Membrane Technique: A Case Report

Clinical characteristics, treatment and efficacy of calcaneal osteomyelitis: a systematic review with synthesis analysis of 1118 reported cases

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