Tuberculous Dactylitis in Adult – A Case Report and Review of Literature

INTRODUCTION: Tubercular dactylitis is an uncommon form of musculoskeletal tuberculosis (TB), especially after the age of 5 years without any risk factors. CASE REPORT: A case of 49-year-old male presented with pain, swelling, and discharging sinus of proximal phalanx of third digit of the right hand with no constitutional symptoms for 2 years, with multiple failed treatment in form of antibiotic therapy. There were no risk factors such as immunodeficiency or any co-morbidities. The plain radiograph was suggestive of increased bone density with mild periosteal reaction; magnetic resonance imaging was suggestive of tubercular osteomyelitis. A biopsy was performed, the gene expert of the sample revealed TB with no drug resistance. The patient was managed with anti-tubercular drugs with complete resolution of clinical and radiological symptoms at 1-year follow-up. CONCLUSION: TB should be considered a differential in patients with chronic soft-tissue or skeletal lesions even in the absence of the usual risk factors because with treatment it still carries a good prognosis.