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BMJ Case Reports 2017; doi:10.1136/bcr-2017-222735
  • Rare disease
  • CASE REPORT

Mycobacterium tuberculosis of the elbow joint

  1. Sulman Hasnie2
  1. 1Department of Orthopaedics, Queen Elizabeth University Hospital, Glasgow, UK
  2. 2Department of Microbiology, Glasgow Royal Infirmary, Glasgow, UK
  1. Correspondence to Dr Quintin Liao, q.liao1{at}nhs.net
  • Accepted 27 November 2017
  • Published 6 December 2017

Summary

Mycobacterium tuberculosis(TB) affecting the elbow joint is rarely reported in the developed world. We present the case of an 85-year-old Caucasian female who complained of a chronically discharging and painful wound across her left elbow during her admission for an ischaemic stroke. This was initially deemed to be either a bursitis or local manifestation of amyloid by her general practitioner and dermatologist respectively prior to admission. She was commenced on flucloxacillin by the medical team for presumed cellulitis with minimal response. A synovial fluid sample and repeated wound swabs yielded no growth from routine bacterial culture. Radiological assessment together with knowledge of her husband having previous TB raised the possibility of TB arthritis. Synovial fluid aspirate was subsequently sent for acid–alcohol fast bacilli microscopy and mycobacterial culture that confirmed M. tuberculosis. She was consequently started on multidrug TB therapy, over a year after the onset of her symptoms.

Footnotes

  • Contributors QL involved in drafting the manuscript and obtaining patient consent. JGS involved in providing information on microbiological analysis and also involved in editing of manuscript. SH involved in final editing.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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