Authors: Catarina Pinto da Silva, Flávia Ramos, Rita Sevivas, Luís Fabião, Márcia Ribeiro.
Tuberculosis persists as a significant public health challenge, particularly in developed countries, where atypical manifestations, including osteoarticular involvement, often complicate diagnosis. This case highlights the diagnostic difficulty in distinguishing osteoarticular tuberculosis from septic arthritis. We report an 81-yearold male with a history of hypertension and cerebrovascular disease who presented with a two-week history of persistent fever and an abscessed lesion in the left axilla. Initial imaging and microbiological analysis suggested septic arthritis, leading to antibiotic treatment.
However, the patient’s condition deteriorated, prompting further investigation that revealed lytic lesions and osteomyelitis. Surgical intervention confirmed the presence of acid-fast bacilli and Mycobacterium tuberculosis in culture. This case underscores the necessity for a high index of suspicion for mycobacterial infections in elderly patients presenting with arthritis-like symptoms, the importance of a multidisciplinary approach, and the relevance of timely diagnosis and treatment in improving patient outcomes
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