LOCAL SAMPLE FOR THE DIAGNOSIS OF OSTEOAR TICULAR TUBERCULOSIS

Bone and joint tuberculosis have recently gained a renewal of interest , especially with the spread of HIV infection which may increase its f requency. Bone and joint locations of tuberculosis are pauci-bacillary often requiring local sampling in order to confirm tile diagnosis and to initiate early therapy. From 1983 to 1992 we have studied 19 patie nts with bone and joint tuberculosis. Seventeen local sampling were pe rformed: 12 biopsies and five abscess punctures. Pathological examinat ion of samples disclosed diagnosis of tuberculosis in eight cases out of 12. Among the remaining four patients, direct smear was positive on ce, and cultures grew Mycobacterium tuberculosis in two, yielding the diagnosis in 11 out of the 12 patients. Bacteriological and pathologic al examinations were non contributive in only one patient. Microbiolog ical examination of pus disclosed two positive direct smear and three positive cultures. Treatment lasted 9 to 18 months. The outcome was fa vourable in all patients.