Faria Malik.
An experience with Tuberculous Osteomyelitis in teaching hospitals of Lahore.
Biomedica Jan ;21(2):103-7.

The conclusive diagnosis of tuberculous osteomyelitis requires isolation of Mycobacterium tuberculosis in aspirate from bone lesion and bone debridement. The present study was undertaken to find mycobacterial aetiology in osteomyelitis cases reported to four hospitals in Lahore. One hundred and fifty patients were selected from outpatient departments and Orthopaedic wards of Lahore General Hospital, Sir Ganga Ram Hospital, Services Hospital and Mayo Hospital, Lahore. Specimens of pus from bones and bone debridement were collected. All samples were decontaminated and inoculated on two Lowenstein Jensen slopes. Smears were made and stained by the Ziehl Neelsen method for acid fast bacilli. The Lowenstein Jensen slopes were examined biweekly for eight weeks and any growth obtained was stained by the Ziehl Neelsen method. Cultures for pyogenic bacteria were also put up both for aerobes and anaerobes. Thirteen cases were positive for Mycobacterium tuberculosis: five cases had mycobacterium isolated as a single pathogen, whereas in seven cases there was concurrent infection with Staphylococcus aureus, enterobacteriaceae or both. One case presented with a mixed infection with mycobacterium, Staphylococcus and an anaerobe. These patients were clinically suggestive of tuberculosis on the basis of history, symptoms and signs general andor pulmonary, typical involvement of spine, chronicity or refractoriness to surgical and antibiotic therapy. The present study highlights the importance of tuberculosis in chronic cases of osteomyelitis. All cases should be cultured for Mycobacterium tuberculosis as it can occur alone or with concomitant pyogenic infection masking its presence leading to failure of therapy.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com