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 63
- Downloads 0
Colour Doppler Study in Differentiating Malignancy and Benign Breast Lumps
Background: Colour Doppler sonography and Pulsed Doppler sonography have been used for last several years to evaluate breast tumours. But there are as yet no reliable investigational standards in colour Doppler sonograph...
Relationship of Scabies and Iron Deficiency Anemia in Children of 3-12 Year Age Group: A Hospital Based Survey
Introduction: Scabies and iron deficiency anemia is quite common in developing countries like India. Objectives: The prime objective of the study is to evaluate the potent relationship of scabies and iron deficiency anem...
An Estimation of Hospital Based Incidence of Neonatal Hyperbilirubinemia in Term Newborns and Associated Risk Factors in a North Indian Setting
Objective: To estimate the incidence of neonatal hyperbilirubinemia in newborns and associated risk factors. Study design: Prospective cross-sectional study. Study site: Department of Pediatrics, Integral Institute of Me...
Prevalence of Perceived Stress and Obesity among Women Before and After Menopause
Background: Menopause is one of the critical periods of a women’s life during which weight gain and onset or worsening of obesity are favored. At this period the prevalence of obesity is the highest. Aim: The present stu...
Diagnostic Reference Levels: A Review
The radiation dose delivered to patients undergoing specific medical x-ray examinations might vary among practices due to the difference in energy, filtration, and technique used to acquire images. In order to minimize t...