Bone and Joint Tuberculosis in Bamrasnaradura Infectious Disease Institute

Abstract

The objective of this study were to study the clinical characteristics of bone and joint tuberculosis in HIV-positive and HIV-negative patients and to study predisposing factors and management. A retrospective study of 21 patients with bone and joint tuberculosis attended at Bamrasnaradura Infectious Diseases Institute from March 2002 through July 2006 was done by reviewing medical records in detail. The study group comprised of 13 HIV positive (61.9%) and 8 HIV negative patients (38.1%). The clinical presentation of bone and joint tuberculosis were similar in HIV positive and negative patients. The most important symptom was chronic pain which were presented in all patients, average 22.9±9.1 months in HIV-negative and 9.1± 3.0 months in HIV positive patients. The elderly more than 60 year old was a significant risk factor in HIV negative patients (75% in HIV negative vs. 0% in HIV positive patients who were older than 60 years old, p < 0.001). In HIV positive patients, the history of prior contacted or infected with tuberculosis was a significant risk factor for reactivated extra-pulmonary tuberculous infection in bone and joints (1.3% in HIV negative vs. 62.5% in HIV positive patients, p = 0.027). The CD4 count which was represented the immunologic status of the patients had less effect (46.2% of the HIV positive patients had CD4 level more than 200 cell/mm3). The result of anti-tuberculosis drugs given for at least 12 months was satisfactory. No recurrent infection nor serious complication was found.