Journal of the Korean Pediatric Society 1968;11(2):91-94.
Published online February 28, 1968.
Two Cases of Spontaneous Fractures in Miliary Tuberculosis and Tuberculous Meningitis
Chang Hyup Kim, Jong Hyuck Lee, Kyung Ja Lee, Sang Jhoo Lee
Dept, of Pediatrics, Hanil Hospital, Seoul, Korea.
粟粒結核 및 結核性 腦膜炎에 供發한 特發性 骨折의 2例
金昌 協, 李 鍾 赫, 李 廣 子, 李 尙 柱
韓一病院 小兒科
Abstract
Only few cases describing spontaneous fractures in tuberculous meningitis were reported in the literatures. Recently, we experienced two such cases, who daring their treatment for miliary tuberculosis and tuberculous meningitis developed spontaneous fractures of the lower extremities. Case 1: A 3 year and 4 month old Korean boy was admitted to Hanil Hospital on September 8,1966, with chief complaints of high fever, vomiting, convulsion and subsequent unconsciousness.A spinal tap revealed 175 mg% of protein, llmg% of sugar, and 26 cells, predominantly lymphocytes. X-ray of the chest revealed miliary tuberculosis. On the basis of clinical, roentgenographic and laboratory findings, he was diagnosed as a case of miliary tuberculosis combined by tuberculous meningitis and intensively treated with streptomycin, isoniazid and prednisolone. Eleven months after admission, painful swelling on the left knee joint was noted without any forceful stimuli. An X-ray revealed a green-stick* s fracture of the distal part of the left femur. After 3 weeks* immobilization therapy the X-ray showed satisfactory union of the fracture. Case 2: A 1 year and 4 month old Korean boy was admitted to Hanil Hospital on June 21, 1967,because of fever, vomiting, convulsion and semicomatous condition of 10 days’ duration. Tuberculin reaction was strongly positive. The cerebrospinal fluid with pellicle revealed 110.5 mg% of protein, 27.9 mg% of sugar and 210 cells, mostly lymphocytes. The patient was intensively treated with streptomycin, isoniazid, P.A.S. and prednisolone and made a satisfactory recovery. Three and half month after admission, crawling on the floor, the patient cried vigorously and we found the painful swelling of the right thigh. Roentgenogram revealed oblique fracture of mid portion of the right femur without dislocation which on subsequent X-ray showed an actual callus formation.




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