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Tuberculous Pyomyositis: A Rare but Serious Diagnosis

Tuberculous pyomyositis is a rare clinical entity with serious consequences if a diagnosis is not established early. A 53-year-old female with a past medical history of sarcoidosis and pulmonary fibrosis presented from an outside hospital with persistent fevers and a rash. She had been hospitalized...

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Autores principales: Krishnasamy, Vikram, Joseph, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619691/
https://www.ncbi.nlm.nih.gov/pubmed/23634147
http://dx.doi.org/10.1155/2013/126952
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author Krishnasamy, Vikram
Joseph, Matthew
author_facet Krishnasamy, Vikram
Joseph, Matthew
author_sort Krishnasamy, Vikram
collection PubMed
description Tuberculous pyomyositis is a rare clinical entity with serious consequences if a diagnosis is not established early. A 53-year-old female with a past medical history of sarcoidosis and pulmonary fibrosis presented from an outside hospital with persistent fevers and a rash. She had been hospitalized multiple times at an outside hospital without any improvement in her symptoms. On examination, she was noted to have a large area of left upper lower extremity (LUE) tenderness with superimposed erythema. Laboratory data revealed a white blood cell count of 22,300. Computed tomography (CT) scans of the LUE, chest, and left lower extremity (LLE) showed multiple intramuscular abscesses in those regions without evidence of osteomyelitis. Subsequent drainage of the abscesses and resulting cultures revealed Mycobacterium tuberculosis. The patient was started on therapy with rifampin, isoniazid, pyrazinamide, and ethambutol. However, the patient developed hepatitis on these agents and subsequently went into septic shock with multiorgan failure. Care was eventually withdrawn as a result of a poor prognosis. This case illustrates the severe consequences of TB pyomyositis if not diagnosed promptly. While tuberculosis is uncommon in the United States, it should be an important consideration in the differential diagnosis of immunocompromised patients.
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spelling pubmed-36196912013-04-30 Tuberculous Pyomyositis: A Rare but Serious Diagnosis Krishnasamy, Vikram Joseph, Matthew Case Rep Med Case Report Tuberculous pyomyositis is a rare clinical entity with serious consequences if a diagnosis is not established early. A 53-year-old female with a past medical history of sarcoidosis and pulmonary fibrosis presented from an outside hospital with persistent fevers and a rash. She had been hospitalized multiple times at an outside hospital without any improvement in her symptoms. On examination, she was noted to have a large area of left upper lower extremity (LUE) tenderness with superimposed erythema. Laboratory data revealed a white blood cell count of 22,300. Computed tomography (CT) scans of the LUE, chest, and left lower extremity (LLE) showed multiple intramuscular abscesses in those regions without evidence of osteomyelitis. Subsequent drainage of the abscesses and resulting cultures revealed Mycobacterium tuberculosis. The patient was started on therapy with rifampin, isoniazid, pyrazinamide, and ethambutol. However, the patient developed hepatitis on these agents and subsequently went into septic shock with multiorgan failure. Care was eventually withdrawn as a result of a poor prognosis. This case illustrates the severe consequences of TB pyomyositis if not diagnosed promptly. While tuberculosis is uncommon in the United States, it should be an important consideration in the differential diagnosis of immunocompromised patients. Hindawi Publishing Corporation 2013 2013-03-24 /pmc/articles/PMC3619691/ /pubmed/23634147 http://dx.doi.org/10.1155/2013/126952 Text en Copyright © 2013 V. Krishnasamy and M. Joseph. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Krishnasamy, Vikram
Joseph, Matthew
Tuberculous Pyomyositis: A Rare but Serious Diagnosis
title Tuberculous Pyomyositis: A Rare but Serious Diagnosis
title_full Tuberculous Pyomyositis: A Rare but Serious Diagnosis
title_fullStr Tuberculous Pyomyositis: A Rare but Serious Diagnosis
title_full_unstemmed Tuberculous Pyomyositis: A Rare but Serious Diagnosis
title_short Tuberculous Pyomyositis: A Rare but Serious Diagnosis
title_sort tuberculous pyomyositis: a rare but serious diagnosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619691/
https://www.ncbi.nlm.nih.gov/pubmed/23634147
http://dx.doi.org/10.1155/2013/126952
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