EspPulmonary and Multifocal Osseous Tuberculosis in an Immunocompetent Patient: Case Reportañol

Authors

DOI:

https://doi.org/10.20453/rmh.v35i2.5234

Keywords:

Tuberculosis extrapulmonary, Immunity, Tuberculosis osteoarticular, Polymerase Chain Reactio

Abstract

Extrapulmonary Tuberculosis, accounting for 14% of total tuberculosis cases, represents an uncommon manifestation, with osteoarticular involvement being a rare form. We present the case of a 28-year-old male patient who initially exhibited respiratory symptoms and subsequently developed acute pain and swelling in the second finger of the right hand after exertion. Specific treatment was initiated at a peripheral center upon the isolation of Mycobacterium tuberculosis in sputum. However, due to persistent symptoms and the need for further investigations, the patient was referred to a more specialized center. A biopsy of the swelling was performed, yielding a positive result for GeneXpert MTB/RIF. The initial anatomopathological description prompted further investigation, including a biopsy of an incidentally discovered vertebral lesion at the D9 level. Both reports concluded that the lesions were secondary to tuberculosis. In summary, a diagnosis of disseminated tuberculosis with multifocal osteoarticular involvement was established, and the patient continues the sensitive antitubercular treatment regimen.

Author Biographies

Ramon Rolando Cámara-Reyes, RRCR, Hospital Nacional Alberto Sabogal Sologuren

      

Marco Antonio Zuñiga-Rosas, MAZR, Español

     

References

World Health Organization (WHO). Global tuberculosis report. 2023. Disponible en: https://iris.who.int/bitstream/handle/10665/373828/9789240083851-eng.pdf?sequence=1

Purohit M, Mustafa T. Laboratory diagnosis of extrapulmonary tuberculosis (EPTB) in resource- constrained setting: state of the art, challenges and the need. J Clin Diagn Res. 2015; 9:EE01eEE06.

Kulchavenya E. Extrapulmonary tuberculosis: are statistical reports accurate? Ther Adv Infect Dis. 2014; 2(2):61–70. doi: 10.1177/2049936114528173.

Villena-Suarez JR, Vicente W, Taxa L, Cuéllar L, Nuñez-Butrón MT, Villegas V et al. Tuberculosis que imita cáncer: casos derivados al Instituto Nacional de Enfermedades Neoplásicas, Lima-Perú. Rev perú med exp salud publica. 2018; 35(1):77-83. doi:10.17843/rpmesp.2018.351.3602.

Análisis Situacional de la Tuberculosis Región Callao; 2021. Disponible en: https://www.diresacallao.gob.pe/wdiresa/documentos/boletin/epidemiologia/asis/FILE0006702016.pdf

Ministerio de Salud. NTS Nº200-MINSA/DGIESP-2023. Norma Técnica de Salud para el Cuidado Integral de la Persona afectada por Tuberculosis, Familia y Comunidad. Lima. MINSA. 2023. Disponible en: https://bvs.minsa.gob.pe/local/fi-admin/RM-339-2023-MINSA.pdf

Dong J, Wang H. Multisystemic tuberculosis presenting with pulmonary, pleura, intestinal and bone involvement. Am J Med Sci. 2022; 364(5):e4-e5. Doi:10.1016/j.amjms.2022.05.024

Adhikari S, Basnyat B. Extrapulmonary tuberculosis: a debilitating and often neglected public health problem. BMJ Case Rep. 2018; 11(1):e226098. Doi:10.1136/bcr-2018-226098

Lynn MM, Kukanesen JR, Khan AW. Troublesome Tuberculosis: A Case Report on Multi-focal Tuberculous Osteomyelitis in An Immunocompetent Patient. J Clin Med Res. 2012; 4(1):73-6. Doi:10.4021/jocmr758e

Chaudhry LA, Eissa EB, Chaudhry S. A 35-year-old immuno-competent male with open pulmonary tuberculosis associated with extra-ordinary extensive extra-pulmonary tuberculosis. Int J Mycobacteriol. 2013; 2(3):183-6. Doi:10.1016/j.ijmyco.2013.05.005

Sharma BK, Singh VK, Nishant K, Das D. Scapular bone destruction: do not forget to think of tuberculosis in endemic areas. BMJ Case Rep. 2013; 2013:bcr2013200051. Doi:10.1136/bcr-2013-200051

Singh J, Dinkar A. Positive outcome of pulmonary tuberculosis associated with extraordinary extensive extrapulmonary tuberculosis in an immunocompetent adult. Int J Mycobacteriol. 2018; 7(2):183-185. Doi:10.4103/ijmy.ijmy_61_18

Yu Y, Kong Y, Ye J, Wang A. Performance of conventional histopathology and GeneXpert MTB/RIF in the diagnosis of spinal tuberculosis from bone specimens: A prospective clinical study. Clin Biochem. 2020; 85:33-37. Doi: 10.1016/j.clinbiochem.2020.08.010

Published

2024-06-28

How to Cite

1.
Cámara-Reyes RR, Zuñiga-Rosas MA. EspPulmonary and Multifocal Osseous Tuberculosis in an Immunocompetent Patient: Case Reportañol. Rev Méd Hered [Internet]. 2024 Jun. 28 [cited 2024 Jul. 2];35(2):96-102. Available from: https://revistas.upch.edu.pe/index.php/RMH/article/view/5234

Issue

Section

CASE REPORTS