Abstract | HISTORY: A 56-year-old male patient has suffered from increasing pain in the left foot which limited the ability of walking since 18 months. There was a soft and painful swelling below the left inner ankle. In addition the patient reported back pain, but no neurological symptoms. Insulin dependent diabetes type II was known for 20 years, and a diabetic foot syndrome was suspected. 6 months prior the patient consulted his physician because of repeated acute bronchitis with expectoration and no improvement following antibiotic therapy. INVESTIGATIONS: Osteolytic destruction of the left middle foot and the tarsal with soft tissue infiltration according to MR, a spondylodiscitis of the lumbar vertebra I and II (MR) and mixed interstitial/alveolar infiltrates throughout the lung with a predominance in both upper lobes were found. The microbiological examination of sputum and biopsy of inflamed soft tissue of the left ankle revealed infection with mycobacterium tuberculosis. DIAGNOSIS: THERAPY AND CLINICAL COURSE: CONCLUSION: A combination of symptoms resulting from inflammatory bone processes and pulmonary symptoms is always suspicious for a hematogenic dissemination of a pulmonary tuberculosis.
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Authors | A Güttler, S Hammerschmidt, H Wirtz, J Schauer |
Journal | Deutsche medizinische Wochenschrift (1946)
(Dtsch Med Wochenschr)
Vol. 129
Issue 22
Pg. 1243-5
(May 28 2004)
ISSN: 0012-0472 [Print] Germany |
Vernacular Title | Unerwartete Ursache einer Fusswurzeldestruktion bei einem Diabetiker. |
PMID | 15170580
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Diabetes Mellitus, Type 2
(complications)
- Diabetic Foot
(diagnosis)
- Diagnosis, Differential
- Discitis
(diagnosis)
- Humans
- Lumbar Vertebrae
(pathology)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Mycobacterium tuberculosis
(isolation & purification)
- Radiography
- Radionuclide Imaging
- Sputum
(microbiology)
- Tarsal Bones
(diagnostic imaging, microbiology, pathology)
- Tuberculosis, Osteoarticular
(diagnosis)
- Tuberculosis, Pulmonary
(diagnosis, diagnostic imaging)
- Tuberculosis, Spinal
(diagnosis)
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