Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Putzl, L.
Differential diagnosis TB: Analysis and evaluation of patients with tuberculosis affecting the bones and soft tissues, a retrospective study
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 58
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Scheipl Susanne
- Vielgut Ines
- Altmetrics:
- Abstract:
- Introduction: Cases of musculoskeletal tuberculosis (TB) have become increasingly rare in the Austrian population. Younger physicians often only learn about these cases from textbooks. Therefore, this study aims to make doctors aware again of the differential diagnosis of tuberculosis, and in particular of its extrapulmonary form affecting the musculoskeletal system. Material and Methods: This retrospective study consists of: (1) an enquiry and analysis of the national TB registry data (1995-2019), (2) the retrospective assessment of patients treated with musculoskeletal TB at our institution since the initiation of electronic records (2005-2019), and (3) the evaluation of clinical guidelines for TB prevention and reporting in a clinical setting. Results: (1) In Austria, a total of 23,120 patients were diagnosed with TB between 1995 and 2019. Amongst these, 307 had a principal manifestation of musculoskeletal TB (1.33%). (2) This retrospective study includes 17 participants, nine men (52.94%) and eight women (47.06%). Patients with a migration background (n = 8; 47.06%) were diagnosed under the age of 40 (with a range from 18-39 years) whereas all native Austrians (n = 9; 52.94%) were diagnosed over the age of 60 (with a range from 63-92 years). Ten out of 17 patients (58.82%) presented with a spinal form of musculoskeletal TB. The most frequent causes for the presentation were septic or inflammatory conditions (41.18%), neurological deficits (29.41%), or suspected neoplastic processes (29.41%). At the median, we initiated TB-specific diagnostic procedures on the 14th day (with a range from 7-405 days) after initial presentation. Six patients received a purely conservative treatment (35.29%), whereas the remaining eleven patients (64.71%) additionally underwent surgery. Discussion: Timely initiation of drug therapy can prevent secondary TB complications. Therefore, physicians should consider TB as a potential differential diagnosis in case of atypical infectious events in the musculoskeletal system.