Pediatric Infection and Vaccine

The Korean Society of Pediatric Infectious Diseases (대한소아감염학회)
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A Case of Tuberculous Arthritis on Left Knee Joint in a Child

소아에서 발생한 슬관절의 결핵성 관절염

  • Lee, Hye Jin (Department of Pediatrics, College of Medicine, The Catholic University) ;
  • Lee, Ji Hun (Department of Pediatrics, College of Medicine, The Catholic University) ;
  • Mok, Hye Rin (Department of Pediatrics, College of Medicine, The Catholic University) ;
  • Lee, Soo Young (Department of Pediatrics, College of Medicine, The Catholic University) ;
  • Kang, Jin Han (Department of Pediatrics, College of Medicine, The Catholic University)
  • 이혜진 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이지헌 (가톨릭대학교 의과대학 소아과학교실) ;
  • 목혜린 (가톨릭대학교 의과대학 소아과학교실) ;
  • 이수영 (가톨릭대학교 의과대학 소아과학교실) ;
  • 강진한 (가톨릭대학교 의과대학 소아과학교실)
  • Published : 2006.11.30
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Abstract

Tuberculosis still ranks as one of the three most important infectious diseases in the world in terms of morbidity and mortality. In Korea, an increased incidence of tuberculosis has been observed in recent years. With the resurge of tuberculosis, extrapulmonary tuberculosis has increased, too. From this point of view, tuberculous arthritis affecting knee is rare in all forms of tuberculosis, but we can consider tuberculous arthritis in patients with osteomyelitis. We report the case of a 14-month-old male child who presented with fever and swelling on the left knee joint. Histologic examination of knee joint fluid showed consistent with tuberculosis. Ziehl-Neelsen stain of joint fluid was positive for acid-fast bacilli(AFB). The outcome was favorable after treatment with anti-tuberculosis medication. Because clinical signs and symptoms of musculoskeletal tuberculosis in children is more indolent, we can misdiagnose or delay diagnosis. The diagnosis of tuberculous arthritis can be elusive, necessitating a high index of suspicion.

국내에서는 아직도 소아연령에서 결핵 감염이 적지 않게 존재하기 때문에 폐외 결핵 환자가 발생될 위험도 지속적으로 존재한다. 이런 측면에서 폐외 결핵의 하나인 골관절 결핵은 매우 드물기는 하나, 관절염을 주소로 내원한 환자의 원인으로 고려해 볼만하다. 나이 어린 소아에서는 증상과 징후가 비특이적이기 때문에 오진이나 진단 지연이 우려되므로, 항생제 치료에 잘 반응하지 않는 관절염 환자에서는 결핵성 골관절염에 대한 진단과 치료를 시도하는 것이 중요하다.

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