Ema Dianita
Internal Medicine, Saiful Anwar Hospital - Brawijaya University, Indonesia
Title: Poncet’s disease & Gastrocnemius abcess : an unusual presentation of tuberculosis in a diabetic man
Biography
Biography: Ema Dianita
Abstract
Poncets’s disease (tuberculous rheumatism) was rare and challenging complication of tuberculosis (TB) infection, therefore frequently missed. It can happen in all TB-infection phase and should be one of many differential diagnosis of poly- or oligoarthritis in TB endemic area.
We describe the case of a 47-year-old Asian man who presented with active tuberculosis where two week-reactive bilateral arthritis of the knee was the symptom followed pulmonary manifestation. He was treated with anti tuberculosis drugs for four months before arthritis appeared. Poncet’s disease was our diagnosis and 6-month antituberculosis , as well as non steroid antiinflammatory drugs (NSAID) were given. Diabetes mellitus was the only risk factor of this immunocompromised state.
Two weeks later, bilateral gastrocnemius abcess then tought as complication of the arthirits. But, unmatched conventional culture result of synovial fluid and abcess made us wondered if Poncet’s disease is really sterile reactive arthritis or there was undetected microbe artefact?. Furthermore, his arthritis and abcess completely respond to 3rd generation of Cephalosporin as the first choice of antibiotic according to abcess culture.
This case highlights the need for increased awareness among physicians regarding this rare complication of common disease to avoid delay in diagnosis and starting the appropriate treatment.