Tuberculous coxitis with trochanteric bursitis manifesting a year after immigration to Germany: a case report

J Med Case Rep. 2018 Nov 7;12(1):332. doi: 10.1186/s13256-018-1867-9.

Abstract

Background: Osteoarticular tuberculosis is rare in Germany. In particular, trochanteric bursitis is an extremely rare manifestation of osteoarticular tuberculosis. We describe a case of tuberculous coxitis with trochanteric bursitis, successfully treated with a fourfold tuberculostatic therapy.

Case presentation: We report the case of a 43-year-old human immunodeficiency virus-negative Sudanese man with osteoarticular tuberculosis, who was originally admitted with the suspected diagnosis of ankylosing spondylitis. Low grade fever together with the positive result of an interferon-gamma release assay test as well as findings from magnetic resonance imaging provided clues to the diagnosis. A definitive diagnosis could be set after a computed tomography-guided biopsy.

Conclusions: Apart from a rare involvement pattern of osteoarticular tuberculosis, including trochanteric bursitis, this case highlights the increasing importance of osteoarticular tuberculosis as a differential diagnosis of rheumatic disorders. With the growing migration flows from tuberculosis-endemic African countries, clinicians in central and northern Europe may be more frequently confronted with atypical involvement patterns of osteoarticular tuberculosis.

Keywords: Coxitis; Trochanteric bursitis; Tuberculosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use*
  • Bursitis / drug therapy*
  • Bursitis / physiopathology*
  • Emigrants and Immigrants*
  • Femur / physiopathology*
  • Deutschland
  • Humans
  • Male
  • Sudan
  • Treatment Outcome
  • Tuberculosis, Osteoarticular / diagnosis*
  • Tuberculosis, Osteoarticular / drug therapy*

Substances

  • Antitubercular Agents