Tuberculous Arthritis Diagnosed by Metagenomic Sequencing after Negative Microbiology Studies and a 4-Year Delay.
Lu Yang, Li Xiang, Jin Rilong et al.
✦ AI-curated · Sources linked
Case in brief
A 70-year-old man receiving treatment for lung cancer had chronic left knee pain and recurrent swelling. Two arthroscopic procedures were performed, but repeated standard tuberculosis tests were negative. Metagenomic next-generation sequencing (mNGS) later detected Mycobacterium tuberculosis, establishing tuberculous arthritis after a prolonged diagnostic delay. Following one year of triple-antituberculous therapy, he was asymptomatic at the two-year follow-up.
What made this case unusual
The diagnosis was made by mNGS after repeated standard tuberculosis studies were negative, in a patient with chronic knee disease and a prolonged diagnostic delay.
Diagnostic / clinical pearl
Tuberculous arthritis can remain a consideration in chronic, culture-negative arthropathy; mNGS may help identify paucibacillary extrapulmonary tuberculosis when standard studies are unrevealing.