Neglected tuberculous trochanteric bursitis in an adolescent girl: A case report and literature review
Josip Vlaic1
, Ivan Pavic2,3, Ana Tripalo Batos4, Ljiljana Zmak5,6, Bozo Kruslin7,8
1Division of Paediatric Orthopaedic Surgery, Children’s Hospital Zagreb, Zagreb, Croatia
2Department of Pulmonology, Allergology and Immunology, Children’s Hospital Zagreb, Zagreb, Croatia
3Department of Paediatrics, School of Medicine, University of Split, Split, Croatia
4Department of Paediatric Radiology, Children’s Hospital Zagreb, Zagreb, Croatia
5National Reference Laboratory for Tuberculosis, Croatian National Institute of Public Health, Zagreb, Croatia
6Department of Medical Microbiology and Parasitology, School of Medicine, University of Zagreb, Zagreb, Croatia
7Department of Pathology, Sestre Milosrdnice University Hospital Centre, Zagreb, Croatia
8Department of Pathology, School of Medicine, University of Zagreb, Zagreb, Croatia
Keywords: Adolescent, anti-tuberculosis drugs, surgery, tuberculous trochanteric bursitis
Abstract
Tuberculous trochanteric bursitis (TTB) is an extremely rare form of extrapulmonary tuberculosis. Due to a low clinical suspicion and poor collaboration among medical professionals, the diagnosis of TTB can be often delayed. In this report, we describe a case of neglected TTB in an adolescent girl that initially presented with right thigh swelling and fluctuance. The patient underwent repeated unsuccessful surgical treatment; however, dull pain and periodic wound drainage remained for eight years. Complete excision of fistula and trochanteric bursa and one year of oral antituberculous drug therapy led to complete recovery. This case report highlights tuberculosis as a diagnostic challenge, when rare localizations are affected. In addition, this report addresses several diagnostic pitfalls and reviews the literature regarding TTB in adolescent patients. Orthopedic surgeons need to consider TTB, when swelling, fluctuance or repeated wound drainage are present on the thigh.
Citation: Vlaic J, Pavic I, Batos AT, Zmak L, Kruslin B. Neglected tuberculous trochanteric bursitis in an adolescent girl: A case report and literature review. Jt Dis Relat Surg 2021;32(2):536-541.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
We would like thank to Asst. Prof. Martin J. Morrison, III, MD; (Educational Consultant for DePuy Synthes Spine and Educational Consultant for OrthoPediatrics); Loma Linda University Department of Orthopedic Surgery Loma Linda, CA 92354 USA for editing and writing assistance.