BMJ Case Reports 2017; doi:10.1136/bcr-2017-220596
  • Reminder of important clinical lesson

Total knee prosthesis infected with Mycobacterium tuberculosis

  1. Nisreen Al Sherbini2
  1. 1Department of Medicine, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
  2. 2Prince Sultan Military Medical City, Riyadh, Saudi Arabia
  1. Correspondence to Dr Fatehi E Elzein, fatehielzein{at}
  • Accepted 23 August 2017
  • Published 7 September 2017


Mycobacterium tuberculosis (MTB) infection of a prosthetic joint is rarely reported in developed countries.1 Typically, MTB infection involves the hips or knees, and the infection can occur secondary to crushing and degradation of the granuloma during surgery or, less commonly, from distant foci spreading through the blood. In the present case, MTB infection likely resulted from haematogenous spread since multiple hot spots suggestive of MTB infection were noted in other sites. Early diagnosis allows for antitubercular therapy with retention of the prosthesis, while late diagnosis frequently results in removal and reimplantation of the joint. To avoid major surgery, a high index of suspicion is required to diagnose prosthetic joint tuberculosis.


  • Contributors FEE wrote the manuscript and shared the treatment of the patient. MH was the resident following the patient in hospital and shared in collecting the literature. SSA is an orthopaedic surgeon who looked after the patient and revised the surgical part in the case reporting. NAS is the infectious diseases consultant who followed the patient and reviewed the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article