An Overlooked Aetiology of Chronic Arthritis in Children

Nicolae Iagaru e-mail: [email protected] Abstract. TB arthritis is a rare, insidious chronic mono-arthritis resulting in extremely serious destruction of joints and bones. Usually, the possibility of TB arthritis is suggested by family infectious or environmental contact with TB and a positive Test at PPD. The Objectives. Are to discuss about a forgotten etiology of monoarthritis in pediatric patients. The author presents the case of a teenager girl (16 1⁄2 years old) with chronic arthritis of the wrist treated for 6 months in other hospitals, at the onset as acute rheumatic fever and then, as juvenile idiopathic arthritis, oligoarthritis subtype. Although no infected family or environmental contact is known, no predisposing factors, and pulmonary TB are absent, the evolution refractory to treatment with severe joint damages demands a Quantiferon TB Gold Test that comes positive. Surgical evacuation of pus and quadruple tuberculostatic therapy had a favourable outcome with restitution ad integrum.