Metastatic tuberculous abscess: A rare manifestation of cutaneous tuberculosis

Abstract

Cutaneous tuberculosis (CTB), a rare manifestation of tuberculosis is one of the most challenging diagnoses to establish. Metastasic tuberculous abscess is a form of CTB which is characterized by cold abscesses on the patient's extremities or trunk without any involvement of underlying tissue. Here we report a case of 56-year-old Bangladeshi male with no previous history of TB, who presented with multiple abscesses over the body for 3 months. His diagnosis was confirmed on the basis of demonstration of Mycobacterium tuberculosis in the lesions by staining, PCR and culture. But no primary focus was found. After 1 month of anti-tubercular therapy, significant improvement was noted.

Mycobacterium tuberculosis sepsis with multiple intermuscular abscesses and respiratory failure as the main manifestations: a case report

“…Tuberculous abscess is a type of cutaneous tuberculosis that commonly occurs in individuals with compromised immune systems, advanced age, malnutrition, and prolonged use of immunosuppressive medications. It is primarily caused by hematogenous dissemination of Mycobacterium tuberculosis [ 11 ]. Skin tuberculosis accounts for only 1-1.5% of all tuberculosis cases, and subcutaneous abscesses and cold abscesses are rare occurrences [ 12 ].…”

Cold abscess as a primary manifestation of thyroid tuberculosis

“…Thyroid tuberculosis is uncommon probably due to the anti-bactericidal properties of colloids within the thyroid follicles and high vascularization of the gland [3] ⁠. Diagnosis of thyroid tuberculosis is often missed or delayed due to unspecific signs and symptoms and presents in various clinical manifestations including single or multifocal nodules, chronic sinuses, goiter with caseation, chronic fibrosing nodules, and cold or acute abscess [3] , [4] ⁠. In some circumstances, it can mimic thyroid cancer with some mechanical obstruction signs including hoarseness or dysphagia as shown in our case.…”

“…In some circumstances, it can mimic thyroid cancer with some mechanical obstruction signs including hoarseness or dysphagia as shown in our case. Ultrasonography-guided fine-needle aspiration biopsy is appraised as an important procedure to assist the diagnosis for detailed examination of cytology and AFB culture [3] , [4] , [5] ⁠. Although antituberculous therapy remains the mainstay treatment, surgery is still often performed to facilitate abscess drainage and to prevent total destruction of the thyroid tissue [3] , [4] , [5] ⁠.…”

“…Ultrasonography-guided fine-needle aspiration biopsy is appraised as an important procedure to assist the diagnosis for detailed examination of cytology and AFB culture [3] , [4] , [5] ⁠. Although antituberculous therapy remains the mainstay treatment, surgery is still often performed to facilitate abscess drainage and to prevent total destruction of the thyroid tissue [3] , [4] , [5] ⁠. Failure to respond to antituberculous drugs and recurrence occur in around 1% of cases due to multi-drug resistance [3] ⁠.…”