复旦大学：《传染病学 Infectious Disease》课程教学资源（MBBS）教案案例（英文）Tuberculous periprostheticinfection precipitated by infliximab therapy

BMJ Case Reports Tuberculous periprosthetic infection precipitated by infliximab therapy CASE REPORT Tuberculous periprosthetic infection precipitated by infliximab therapy

Tuberculous periprosthetic infection precipitated by infliximab therapy

Part 1 Part 2 Part 3 Part 4 Part 5 Part 6 Part 7 Symptoms &Signs Male. 45 severe pain in his left this g h for 2 weeks symptoms evening rise of temperature for inability to bear weight the past I month no associated anorexia or ankylosing spondylitis Sequential revision total hip weight lOSS 强直性脊柱炎 arthroplasty Physical examination 20 years old 7 years before a tender swelling on the anterior aspect of the thigh with a discharging sinus 22 years old 2 months before bilateral total hip arthroplasty short intravenous course of infliximab because of acute polyarthralgia(多关节痛)

Part 1 Part 2 2 Part 3 Part 4 Part 5 Part 6 Part 7 Symptoms &Signs Male, 45 severe pain in his left thigh for 2 weeks, inability to bear weight 20 years old ankylosing spondylitis 强直性脊柱炎 22 years old bilateral total hip arthroplasty Symptoms: evening rise of temperature for the past 1 month; no associated anorexia or weight loss Physical examination: a tender swelling on the anterior aspect of the thigh with a discharging sinus 7 years before Sequential revision total hip arthroplasty short intravenous course of infliximab, because of acute polyarthralgia (多关节痛) 2 months before

Part 1 Part 2 Part 3 Part 4 Part 5 Part 6 Part7 Investigations Variable On Presentation Erythrocyte sedimentation rates ( ESr) 149 mm/hour C reactive peptide(CRP) 21 mg/L

Part 2 Part 1 3 Part 3 Part 4 Part 5 Part 6 Part 7 Inves0ga0ons Variable On Presenta0on Erythrocyte sedimenta0on rates (ESR) 149 mm/ hour C reac0ve pep0de (CRP) 21 mg/L

Part 1 Part 2 Part 3 Part 4 Part 5 Part 6 Part7 Investigations osteolysis of proximal femur, without loosening or subsidence of implant Immediate postoperative 7 years follow-up X-ray X-ray

Part 2 Part 1 4 Part 3 Part 4 Part 5 Part 6 Part 7 Inves0ga0ons Immediate postoperative X-ray 7 years follow-up X-ray Ø osteolysis of proximal femur, without loosening or subsidence of implant

Part 1 Part 2 Part 3 Part 4 Part 5 Part 6 Part7 Investigations B multifocal cortical breach with a discharging sinus no obvious effusion Coronal section Axial section, showing a draining sinus

Part 2 Part 1 5 Part 3 Part 4 Part 5 Part 6 Part 7 Inves0ga0ons Coronal section Axial section, showing a draining sinus Ø mul0focal cor0cal breach, with a discharging sinus, no obvious effusion