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Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess

Patient: Female, 9 Final Diagnosis: Multifocal osteomyelitic tuberculosis at rare locations with metastatic tuberculosis abscess Symptoms: Lumps at the left elbow joint • lateral side the left hand • lateral side of the left feet Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatol...

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Autores principales: Nataprawira, Heda Melinda, Ediwan, Natasha A., Diana, Inne Arline, Dwiyana, Reiva Farah, Febrina, Dia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474155/
https://www.ncbi.nlm.nih.gov/pubmed/30975973
http://dx.doi.org/10.12659/AJCR.913615
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author Nataprawira, Heda Melinda
Ediwan, Natasha A.
Diana, Inne Arline
Dwiyana, Reiva Farah
Febrina, Dia
author_facet Nataprawira, Heda Melinda
Ediwan, Natasha A.
Diana, Inne Arline
Dwiyana, Reiva Farah
Febrina, Dia
author_sort Nataprawira, Heda Melinda
collection PubMed
description Patient: Female, 9 Final Diagnosis: Multifocal osteomyelitic tuberculosis at rare locations with metastatic tuberculosis abscess Symptoms: Lumps at the left elbow joint • lateral side the left hand • lateral side of the left feet Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology OBJECTIVE: Unusual clinical course BACKGROUND: Multifocal tuberculosis (TB) with more than 1 tuberculous osteoarticular lesion is rare. Furthermore, metastatic tuberculous abscess (MTA) is also a very rare manifestation of cutaneous TB in children. A non-specific, often subtle, early clinical presentation in conjunction with a low prevalence rate constitute obstacles for diagnosis. CASE REPORT: A 9-years old female patient was referred to Hasan Sadikin Pediatric Respirology Outpatient clinic from the Orthopedic Department with lumps at the left elbow joint, lateral side of the left hand, and lateral side of the left foot. Fine needle aspiration biopsy of the lumps suggested a chronic inflammation due to TB. The patient was then started with a course of anti-TB drugs consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol. During the treatment course, she experienced anti-TB drug-induced hepatotoxicity (ADIH). We then switched the regimen to streptomycin and ethambutol for 2 weeks, then reintroduced treatment with the modified British Thoracic Society guidelines regimen. The nodules appeared shrunken after 3 months of treatment with anti-TB drugs. CONCLUSIONS: Increased awareness of unusual manifestations of TB will likely allow for proper diagnosis and management of this common infection. Accordingly, timely diagnosis and management will prevent further debilitating sequelae.
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spelling pubmed-64741552019-05-23 Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess Nataprawira, Heda Melinda Ediwan, Natasha A. Diana, Inne Arline Dwiyana, Reiva Farah Febrina, Dia Am J Case Rep Articles Patient: Female, 9 Final Diagnosis: Multifocal osteomyelitic tuberculosis at rare locations with metastatic tuberculosis abscess Symptoms: Lumps at the left elbow joint • lateral side the left hand • lateral side of the left feet Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology OBJECTIVE: Unusual clinical course BACKGROUND: Multifocal tuberculosis (TB) with more than 1 tuberculous osteoarticular lesion is rare. Furthermore, metastatic tuberculous abscess (MTA) is also a very rare manifestation of cutaneous TB in children. A non-specific, often subtle, early clinical presentation in conjunction with a low prevalence rate constitute obstacles for diagnosis. CASE REPORT: A 9-years old female patient was referred to Hasan Sadikin Pediatric Respirology Outpatient clinic from the Orthopedic Department with lumps at the left elbow joint, lateral side of the left hand, and lateral side of the left foot. Fine needle aspiration biopsy of the lumps suggested a chronic inflammation due to TB. The patient was then started with a course of anti-TB drugs consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol. During the treatment course, she experienced anti-TB drug-induced hepatotoxicity (ADIH). We then switched the regimen to streptomycin and ethambutol for 2 weeks, then reintroduced treatment with the modified British Thoracic Society guidelines regimen. The nodules appeared shrunken after 3 months of treatment with anti-TB drugs. CONCLUSIONS: Increased awareness of unusual manifestations of TB will likely allow for proper diagnosis and management of this common infection. Accordingly, timely diagnosis and management will prevent further debilitating sequelae. International Scientific Literature, Inc. 2019-04-12 /pmc/articles/PMC6474155/ /pubmed/30975973 http://dx.doi.org/10.12659/AJCR.913615 Text en © Am J Case Rep, 2019 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Nataprawira, Heda Melinda
Ediwan, Natasha A.
Diana, Inne Arline
Dwiyana, Reiva Farah
Febrina, Dia
Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess
title Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess
title_full Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess
title_fullStr Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess
title_full_unstemmed Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess
title_short Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess
title_sort multifocal osteomyelitic tuberculosis at rare locations with metastatic tuberculosis abscess
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474155/
https://www.ncbi.nlm.nih.gov/pubmed/30975973
http://dx.doi.org/10.12659/AJCR.913615
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