{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T14:53:37Z","timestamp":1763564017681,"version":"3.44.0"},"reference-count":32,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,8,1]]},"abstract":"<jats:p>A 71-year-old man presented with septic arthritis of the hip with an initial culture growth of methicillin-sensitive <jats:italic>Staphylococcus aureus<\/jats:italic> (MSSA) masking the diagnosis of tuberculosis (TB). Based on joint aspirate culture and sensitivity results, the patient was first diagnosed with MSSA arthritis. He was started on intravenous antibiotics and underwent washout and debridement of hip. During the procedure, the surgeons observed characteristic tubercular changes and samples were sent for tubercular testing. The reports of cultures for acid-fast bacilli and synovial biopsies confirmed our intraoperative suspicion of TB. Antitubercular medication was started and it helped patient to improve quickly. He completed 9 months of tubercular treatment regimen and at completion total hip replacement was offered. At 8-year follow-up, the patient was doing fine with no recurrence of infection in his hip. High index of suspicion for skeletal TB was raised based on clinical and radiological signs especially if there was a delay or absence of response to appropriate therapy.<\/jats:p>","DOI":"10.1136\/bcr-2018-224558","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T06:59:32Z","timestamp":1535007572000},"page":"bcr-2018-224558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["A deceptive presentation of Tuberculosis hip as Staphylococcal infection, its successful management and literature review"],"prefix":"10.1136","volume":"2018","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1885-8446","authenticated-orcid":false,"given":"Chetan Muralidhara Rao","family":"Dojode","sequence":"first","affiliation":[{"name":"Furlong Fellow in Arthroplasty & Revision Surgery, Trauma & Orthopaedic Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing, West Sussex, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Joseph","sequence":"additional","affiliation":[{"name":"Furlong Fellow in Arthroplasty & Revision Surgery, Trauma & Orthopaedic Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing, West Sussex, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirav N","family":"Shah","sequence":"additional","affiliation":[{"name":"Consultant Trauma & Orthopaedic Surgeon, Western Sussex Hospitals NHS Foundation Trust, Worthing, West Sussex, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,8,23]]},"reference":[{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.4172\/2329-910X.1000131","article-title":"Tuberculosis arthritis: epidemiology, diagnosis, treatment","volume":"2","author":"Chou Tseng","year":"2014","journal-title":"Clin Res Foot Ankle"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.2","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1007\/s00586-012-2331-y","article-title":"Bone and joint tuberculosis","volume":"22","author":"Pigrau-Serrallach","year":"2013","journal-title":"Eur Spine J"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.3","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.89B5.18462"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.4","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1097\/SMJ.0b013e318063e69f","article-title":"Osteomyelitis concurrently caused by staphylococcus aureus and mycobacterium tuberculosis","volume":"100","author":"Lee","year":"2007","journal-title":"South Med J"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.5","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1148\/radiographics.20.2.g00mc12449","article-title":"Tuberculosis from head to toe","volume":"20","author":"Harisinghani","year":"2000","journal-title":"Radiographics"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.ijmyco.2015.04.001","article-title":"A rare localization of tuberculosis of the wrist: The scapholunate joint","volume":"4","author":"Sbai","year":"2015","journal-title":"Int J Mycobacteriol"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2006.06.006"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.8","first-page":"127","article-title":"Concomitant tuberculous and septic arthritis of knee joint in a diabetic patient","volume":"10","author":"Shah","year":"2003","journal-title":"JK Pract"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.9","first-page":"102","article-title":"Septic arthritis and tuberculosis arthritis","volume":"1","author":"Garc\u00eda-Arias","year":"2012","journal-title":"J Arthritis"},{"key":"2025082707481928000_2018.aug20_2.bcr-2018-224558.10","unstructured":"Marquez J , Espinoza LR . 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