Persistent Cutaneous Metastatic Tubercular Abscesses Revealing Multifocal Tuberculosis in an Immunocompetent Patient
Anis Hariz *
Faculté de Médecine, Université de Tunis El Manar, 1007, Tunis, Tunisie and Service de Médecine Interne B, Hôpital Charles Nicolle, Tunis, Tunisie.
Mohamed Salah Hamdi
Faculté de Médecine, Université de Tunis El Manar, 1007, Tunis, Tunisie and Service de Médecine Interne B, Hôpital Charles Nicolle, Tunis, Tunisie.
Imène Beji
Faculté de Médecine, Université de Tunis El Manar, 1007, Tunis, Tunisie and Service de Médecine Interne B, Hôpital Charles Nicolle, Tunis, Tunisie.
Noureddine Litaiem
Faculté de Médecine, Université de Tunis El Manar, 1007, Tunis, Tunisie and Service de Dermatologie, Hôpital Charles Nicolle, Tunis, Tunisie.
Meriem Jones
Faculté de Médecine, Université de Tunis El Manar, 1007, Tunis, Tunisie and Service de Dermatologie, Hôpital Charles Nicolle, Tunis, Tunisie.
Eya Cherif
Faculté de Médecine, Université de Tunis El Manar, 1007, Tunis, Tunisie and Service de Médecine Interne B, Hôpital Charles Nicolle, Tunis, Tunisie.
*Author to whom correspondence should be addressed.
Abstract
Tuberculosis remains one of the infections with high mortality rate. Multifocal tuberculosis usually affects immune compromised patients such as Human Immunodeficiency virus carriers. However, patients with no underlying immunodeficiency may still present an extensive and atypical form of tuberculosis. We hereby report the case of a 16-year-old female patient presenting persistent and multiple cutaneous lesions associated with fatigue and loss of appetite which led to the diagnosis of disseminated, multifocal tuberculosis with neurological, musculoskeletal, genital, pulmonary, peritoneal and lymph nodes involvement. Screening for potential underlying immunodeficiency yielded no results. Clinical and radiological outcome was favorable on anti-tuberculosis drugs with complete regression of identified lesions. This case serves as a reminder that tuberculosis remains a challenging diagnosis that encompasses a variety of clinical presentation ranging from cutaneous abscesses to life-threatening conditions such as cerebral tuberculomas even in immune competent patient.
Keywords: Tuberculosis, metastatic tubercular abscesses, multifocal tuberculosis.