Extra-Pulmonary Multidrug Resistant Tuberculosis (MDR-TB) Presenting As Psoas Abcess: A Rare Case Report
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 2
Abstract
Introduction: MDR TB usually occurs in anti tubetubercular treatment defaulters or those with history of contact to MDR TB. But rarely it may occur as a primary case in persons without history of ATT or contact to TB patients. Case Report: A female presented in our hospital with complains of pain in right leg and fever on and off since last 2 months. O/E: The patient had a swelling in right leg of size 30×15×25 mm which was tender, non-pulsatile and oval in shape. She had no history of tuberculosis or contact to tuberculosis in past. Chest xray, sputum examination and CECT Thorax were normal. Monteux test was positive (50mm). So, patient was started on category 1 ATT empirically. USG Abdomen and CECT Abdomen confirmed right psoas abcess, for which pus was drained multiple times and was sent for LPA examination in which resistance to isoniazid and rifampicin was detetcted. Then she was started on 2nd line ATT including kanamycin, pyrazinamide, ethionamide, ethambutol, cycloserine, and levofloaxacin as per weight bands. On starting ATT, her general condition improved and she was discharged on 2nd line ATT. Discussion: Psoas (or illio-psoas) abcess is collection of pus in the illio-psoas muscle compartment. It may arise via contiguous spread from adjacent structures or by the haematogenous route from distant site. USG or CECT Abdomen allow good accuracy for early diagnosis. Conclusion: Extra-pulmonary MDR TB without history of ATT or contact to MDR-TB is rare. High clinical suspicion and gene xpert test may be the key for early and accurate diagnosis of the patient.
Authors and Affiliations
Dr Azad Singh
Keywords
Related Articles
- EP ID EP506251
- DOI -
- Views 58
- Downloads 0
Awareness of Risk Factors for Non Communicable Diseases among Adolescent girls aged 15-17 years in Koti, Hyderabad
Background: In India Non Communicable Diseases (NCDs) are estimated to account for about 53% of all deaths. The importance of adolescent age group lies in the fact that many serious diseases in adulthood have their roots...
I’m Breathless When I Sit – A Rare Case of Right Atrial Myxoma
Abstract
Nurses’ Perception and Practice of Evidence-Based Practice in Federal Teaching Hospital Abakaliki
Evidence-based practice is a problem solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinicians’ expertise and patient preference and values accor...
Evaluation of Role of Autologous Platelet Rich Fibrin in Wound Healing and Bone Regeneration after Mandibular Third Molar Surgery: A Prospective Study
Background: Bony cavities filled with PRF showed healing in the half the time as compared to the time required for physiological healing. Thereby the aim of this study is to evaluate the role of autologous platelet rich...
A Prospective Study on Placental Changes in Pre-Eclamptic Women and Correlation of Severity of Hypertension with Placental Changes and their effect on Neonatal Outcome
Context: Placenta forms a functional unit between mother and fetus. Preeclampsia is regarded as a risk factor in pregnancy and it leads to placental insufficiency. This, in turn causes both maternal and fetal morbidity a...