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A Case of Musculoskeletal Tuberculosis Mimicking Adult-Onset Still's Disease

성인형 스틸병과 유사한 임상양상을 보인 다발성 골 결핵 1예

  • Cho, Jin Kyeong (Department of Internal Medicine, Seoul Medical Center) ;
  • Kim, Min Sung (Department of Internal Medicine, Seoul Medical Center) ;
  • Shin, Jin Ho (Department of Internal Medicine, Seoul Medical Center) ;
  • Jeong, Yeon Sang (Department of Internal Medicine, Seoul Medical Center) ;
  • Kim, Joon Wan (Department of Internal Medicine, Seoul Medical Center) ;
  • Choi, Jae Phil (Department of Internal Medicine, Seoul Medical Center) ;
  • Choi, Byoong Yong (Department of Internal Medicine, Seoul Medical Center)
  • 조진경 (서울특별시 서울의료원 내과) ;
  • 김민성 (서울특별시 서울의료원 내과) ;
  • 신진호 (서울특별시 서울의료원 내과) ;
  • 정연상 (서울특별시 서울의료원 내과) ;
  • 김준완 (서울특별시 서울의료원 내과) ;
  • 최재필 (서울특별시 서울의료원 내과) ;
  • 최병용 (서울특별시 서울의료원 내과)
  • Received : 2013.08.13
  • Accepted : 2013.10.16
  • Published : 2014.06.01

Abstract

A 46-year-old man was admitted to our hospital because of a fever of unknown origin. The patient had a skin rash, arthralgia, and hepatosplenomegaly. Laboratory tests showed leukemoid leukocytosis, a high serum ferritin level (31,200 ng/mL), and abnormal liver function tests. He was initially diagnosed with adult-onset Still's disease (AOSD). However, imaging studies incidentally detected a cold abscess involving the 11th thoracic vertebra. A biopsy of the abscess revealed histologically granulomatous caseous necrosis, positive for M. tuberculosis by polymerase chain reaction. We present a patient with musculoskeletal tuberculosis (TB) that clinically mimicked AOSD. In TB-endemic countries, extrapulmonary TB should be included in the differential diagnosis of AOSD.

저자들은 전신 오한, 피부 발진과 관절통 등을 동반한 원인불명열 환자에서 성인형 스틸병으로 의심하였으나 흉추와 경골을 침범한 골 결핵으로 최종 진단된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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