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 48
- Downloads 0
Management of Peptic Ulcer Perforation is there A Role for Conservative Management? A Research Study at a Tertiary Care Center in North East India
Background – Conservative treatment of perforated peptic ulcer has documented good results in carefully selected patients with fair general condition. The aim of this study is to determine whether surgery could be avoide...
Study about Childhood Epilepsy & Epileptic Syndromes
Epilepsy is the most common neurological disorder of childhood. Most of the cases are idiopathic. Some are benign, needs no treatment and self-remits in adulthood. Aims: To study the clinical profile, aetiological factor...
Sarcoidosis: A Great Masquerader-Case Report
Sarcoidosis is systemic disorder of unknown origin characterized by granulomatous inflammation in different organs , most frequently in lungs and affects people of all racial and ethnic groups. Here we present a case of...
Effects Fentanyl on Hyperbaric Bupivacaine in Spinal Anaesthesia for Caesarean Section
Hyperbaric bupivacaine was the most common drug used in spinal anaesthesia for caesarean section. The aim of this study was to compare the effects of adding fentanyl to intrathecal bupivacaine on the onset and duration o...
Isosorbide Mononitrate in Heart Failure with Preserved Ejection FractionA Review of Literature
The objective of this review is to do a literature search on the effectiveness of isosorbide mononitrate in heart failure patients with preserved ejection fraction. Heart failure with preserved ejection fraction (HF-PEF)...