Calcaneal Osteomyelitis Presenting as a Paradoxical Reaction during Treatment of Multidrug-Resistant Tuberculosis
10.35827/cp.2019.18.2.102
- Author:
Yong Hyun HAN
1
;
Chang Hwa LEE
;
Min Joon BAE
;
Kihun HWANG
Author Information
1. Department of Rehabilitation Medicine, Dong-Eui Medical Center, Busan, Korea. drsheva01@gmail.com
- Publication Type:Case Report
- Keywords:
Tuberculous osteomyelitis;
Heel pain;
Calcaneal tuberculosis
- MeSH:
Abscess;
Calcaneus;
Delayed Diagnosis;
Diagnosis;
Foot;
Heel;
Humans;
Middle Aged;
Mycobacterium tuberculosis;
Orchiectomy;
Osteomyelitis;
Polymerase Chain Reaction;
Testis;
Tuberculosis;
Tuberculosis, Multidrug-Resistant;
Tuberculosis, Pulmonary;
Wounds and Injuries
- From:
Clinical Pain
2019;18(2):102-106
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Tuberculosis in the foot progresses gradually; thus, diagnosis is usually delayed, and early treatment is rarely provided. If osteomyelitis occurs due to delayed diagnosis and treatment, surgical treatment should be considered. We report the case of a 46-year-old man with osteomyelitis of the calcaneus who was diagnosed with multidrug-resistant pulmonary tuberculosis and he was treated with anti-tuberculosis drugs. Bilateral adrenal masses, abscess of both testes and a small wound in the left plantar heel were observed. Both adrenal masses and abscess were regarded as paradoxical reaction of anti-tuberculosis treatment. After 1 month, he developed a pain in the left plantar heel that was compatible with calcaneal osteomyelitis in radiological features. He underwent right orchiectomy for right scrotal abscess aggravation and surgical treatment for left calcaneal osteomyelitis. Mycobacterium tuberculosis was confirmed by polymerase chain reaction. The patient was immobilized by cast for 8 weeks and the heel pain gradually improved.
