Mycobacterium tuberculosis (MTB) is a rare cause of prosthetic joint infection. The diagnosis is challenging especially in cases of latent tuberculosis. QuantiFERON-TB Gold (QFT®) is an interferon-gamma relative assay (IGRA) which is highly specific and sensitive for detection of MTB infection. We report a case of 76-year-old lady diagnosed with tuberculous prosthetic joint infection following total knee replacement. Histological examination of abnormal synovial tissue taken intraoperatively reveals chronic granulomatous lesion and raised suspicion of tuberculous infection in otherwise asymptomatic patient. The tuberculin skin test, MTB acid-fast stain and tuberculosis polymerase chain reaction were negative. The diagnosis dilemma was solved with positive result of QuantiFERON TB Gold Test. The patient was treated with anti-tuberculous drug without any surgical intervention. At five months follow-up, patient was clinically well with no symptoms and signs of infection
Interferon-gamma ; latent tuberculosis ; mycobacterium tuberculosis ; total knee replacement ; tuberculosis

Osteomyelitis refers to an infection of the bone characterized by progressive inflammatory destruction caused by infecting microorganism. Open fracture carries the risk of developing osteomyelitis from 3 to 50% with a high amputation rate. Salvage of the limb is always a challenge and needs perseverance. We report the case of a 44-year-old male with chronic osteomyelitis with successful multiple limb salvage surgeries. The curative approach to chronic osteomyelitis has the following goals including arrest of infection, pain reduction and salvage of limb and function. With regard to survival and function, the result obtained in this case is more promising compared to above knee amputation.