Treatment of Bone and Joint Tuberculosis in France: A Multicentre Retrospective Study

Guillouzouic, A.; Andréjak, Claire; Peuchant, Olivia; Héry-Arnaud, Geneviève; Hamdad, Farida; Lanotte, Philippe; Gaborit, Benjamin; Bernard, Louis; Bémer, Pascale

doi:10.3390/jcm9082529

Cited by 10 publications

(13 citation statements)

References 26 publications

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“…Among our patients, the spine was affected in about 70% of all cases, while, at the time of MDR-OATB diagnosis, 61% of patients had active TB in at least one other localization, predominantly the lungs and lymph nodes. Similar findings have been reported in the literature [2,3,18].…”

Section: Discussionsupporting

confidence: 93%

“…Diagnosing OATB is challenging for several reasons: (i) the detection relies on specific tests, (ii) it is clinically indistinguishable from other chronic infections caused by more common bacterial pathogens, and (iii) the expertise in diagnosing TB has decreased in low-burden countries [18,19]. In the present study, the median time from symptom onset to OATB diagnosis was 3.5 months, which is longer than for overall TB cases in France (2 months) [19] but similar to what was reported recently for bone and joint TB in France [18].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Features and Outcome of Multidrug-Resistant Osteoarticular Tuberculosis: A 12-Year Case Series from France

et al. 2022

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The optimal treatment for osteoarticular infection due to multidrug-resistant tuberculosis strains (MDR-OATB) remains unclear. This study aims to evaluate the diagnosis, management and outcome of MDR-OATB in France. We present a case series of MDR-OATB patients reviewed at the French National Reference Center for Mycobacteria between 2007 and 2018. Medical history and clinical, microbiological, treatment and outcome data were collected. Twenty-three MDR-OATB cases were reported, representing 3% of all concurrent MDR-TB cases in France. Overall, 17 were male, and the median age was 32 years. Six patients were previously treated for TB, including four with first-line drugs. The most frequently affected site was the spine (n = 16). Bone and joint surgery were required in 12 patients. Twenty-one patients (91%) successfully completed the treatment with a regimen containing a mean of four drugs (range, 2–6) for a mean duration of 20 months (range, 13–27). Overall, high rates of treatment success were achieved following WHO MDR-TB treatment guidelines and individualized patient management recommendations by the French National TB Consilium. However, the optimal combination of drugs, duration of treatment and role of surgery in the management of MDR-OATB remains to be determined.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcome of Multidrug-Resistant Osteoarticular Tuberculosis: A 12-Year Case Series from France

et al. 2022

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“…ESTB also affects the proximal long bones, peripheral short tubular bones, carpal and tarsal bones (mostly the calcaneus) and flat bones like the skull, ribs, sternum and iliac bone, as occurred in our ESTB cases. Most of our patients had abscesses (6/9), but only three (33.3 %) fistulized, as reported [10].…”

Section: Discussionsupporting

confidence: 83%

Bone and joint tuberculosis in paediatrics: a 13-year retrospective study

Gouveia

Cabral

Jordão

et al. 2022

Journal of Medical Microbiology

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Introduction. Bone and joint tuberculosis (BJTB) is rare in developed countries, particularly in the paediatric population. Hypothesis/Gap Statement. The clinical features and sequelae of paediatric BJTB in Europe are not well characterized and should be assessed to achieve a better approach. Aim. To assess the management and outcomes of paediatric BJTB. Methodology. Longitudinal observational study of all paediatric patients (0–17 years old) diagnosed with BJTB between 2008 to 2020 in a tertiary-care hospital. Results. We identified 18 patients with BJTB, with a median age of 10 years (IQR 6–14.8), 66.7 % male. Most (72 %) were diagnosed after 2015 and were foreign-born (88.9 %), mainly from Portuguese-speaking African countries, and none had HIV. The most common symptoms were pain (77.8 %), fever (50 %) and bone deformity (44.4 %). Spinal TB (STB) affected 13 (72.2 %) and extra-spinal TB (ESTB) 9 (50 %) patients, and 4 (27.7 %) had both conditions. Diagnostic positive procedures included positive nucleic acid amplification technique (NAAT) (44.4 %), Mycobacterium tuberculosis isolation (44.4 %) and compatible histology (33.3 %). All completed antituberculous drugs for a median of 12 months (IQR 12–13) and nine (50 %) had surgery. Overall, acute complications occurred in 16 (88.9 %) patients – 11/13 (84.6 %) with STB and 5/5 (100 %) with ESTB – and included abscesses, spinal compression, spine deformity and pathological fractures. Sequelae were still present at the 12-month follow-up in seven cases (46.7 %), and were more common in foreign-born patients sent to Portugal to receive medical treatment (66.7 vs 20 %). Conclusions. Paediatric BJTB is difficult to diagnose and has high morbidity, requiring long-term follow-up. Over the last decade, foreign-born TB seems to be increasing, with still longer treatment courses and more acute complications and sequelae.

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“…This recommended that during the female's productive spell, women most commonly have Pott's spine [20][21] . The upper lumbar and lower thoracic regions have been supposed to be the maximum affected region in most studies 22 . Similar to the findings of Sinan et al in our study, it most often concerned the lumbar vertebrae, followed by the thoracic vertebrae.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Study of Magnetic Resonance Imaging (MRI) Findings in Pott’s Spine

Wahid¹,

Akhtar²,

Kamran³

et al. 2022

PJMHS

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Tuberculosis is the very communal infection found globally and can nearly all parts of the human body can be affected by it, mostly affect the chest. Among the tuberculosis of the skeletal system; 50% of cases affect the spinal cord. Tuberculosis infection of the spinal cord results in Gibbus deformity, edema, involvement of intervertebral discs, epidural abscess, paravertebral abscess and edema with bone destruction and vertebrae collapse in the soft tissue planes. The most valuable diagnostic tool is MRI as it can clearly show all of the above results in the spine tuberculosis affected patients. Aim: The objective of this research was to know the pattern of incidence and to analyzed the several Pott’s spine pathological processes by means of the MRI scan. Study Design: A Retrospective study. Place and Duration: In the Radiology Department of HMC Peshawar and Orthopedic Department of BKMC Swabi from August 2021 to January 2022. Methods: This study analyzed MRI scans of 90 identified patients of spinal tuberculosis performed at the Radiology Department to govern the pattern of the several pathological lesions. Results: This study institute Pott's spine to be more common in the 21-50 age group, mostly among men. The lumbar and dorsal vertebrae are often affected and several vertebrae are affected frequently, with the most common affected is the L3 vertebra. The involvement of Intervertebral disc and para and pre-vertebral collections were communal, with epidural collection happening in > 75 of patients. 13.3% of the patients have cord oedema. Conclusions: MRI is very sensitive in detecting various Potts spine pathological processes, and the occurrence patterns of these findings were assessed in this research. As the prevalence and incidence of tuberculosis depends on several sensitive epidemiologically parameters, this research could deliver a standard conclusion against which further results could be compared in future studies. Keywords: Tuberculous spondylitis, lumbar abscess, Gibbus

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Treatment of Bone and Joint Tuberculosis in France: A Multicentre Retrospective Study

Cited by 10 publications

References 26 publications

Clinical Features and Outcome of Multidrug-Resistant Osteoarticular Tuberculosis: A 12-Year Case Series from France

Clinical Features and Outcome of Multidrug-Resistant Osteoarticular Tuberculosis: A 12-Year Case Series from France

Bone and joint tuberculosis in paediatrics: a 13-year retrospective study

Retrospective Study of Magnetic Resonance Imaging (MRI) Findings in Pott’s Spine

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