Primary Extrapulmonary Rifampicin Mono-Resistant Tuberculosis of the Parotid Gland in an Indian Female: The World’s First Case

Tuberculosis presentation at sites other than the lungs is relatively infrequent, and isolated knee involvement without a pulmonary focus is exceptionally rare. Furthermore, there have been no reported cases of primary rifampicin mono-resistant extrapulmonary tuberculosis of the knee in males. In this case, a 24-year-old male patient presented with pain and swelling in his left knee after a fall five years ago. Given the absence of a history of tuberculosis, arriving at a diagnosis posed a significant challenge. However, the diagnosis was ultimately established through cartridge-based nucleic acid amplification tests and clinical link-up with radiometric techniques. Management was based on the latest national guidelines for anti-tuberculous treatment, which were tailored to his weight. To date, he has completed nine months of treatment with a significant improvement in his symptoms. This rare presentation emphasizes the need for a high degree of suspicion even in extrapulmonary tuberculosis cases.

Section: Discussionmentioning

confidence: 69%

Primary Rifampicin Mono-Resistant Extrapulmonary Tuberculosis of the Knee Without Pulmonary Involvement: One of the First Cases of Its Type in an Immunocompetent Male

Yadav

2023

“…Isoniazid is a cornerstone of anti-tubercular chemotherapy, mainly due to its prompt bactericidal activity, low cost, and fewer side effects compared to other anti-tubercular drugs [ 1 , 9 ]. Besides, drug resistance is a man-made issue and is mostly a result of improper administration of anti-tubercular drugs [ 10 ]. Therefore, it is essential that a detailed history of prior exposure to anti-tubercular drugs be obtained before the start of treatment.…”

Section: Discussionmentioning

confidence: 99%

Primary Isoniazid Mono-Resistant Extrapulmonary Tuberculosis Presenting as Cervical Lymphadenitis: The World’s First Case of Its Type

Yadav¹

2023

Tuberculosis is commonly seen in endemic countries. Cases of primary drug resistance are rare. There is a paucity of data related to primary drug resistance at extrapulmonary sites. Herein, a case of primary isoniazid mono-resistant extrapulmonary tuberculosis of the multiple right cervical lymph nodes is presented. This patient reported multiple swellings and discharging sinuses. A battery of investigations with an eye for finding drug resistance led to a definite diagnosis. He was initiated on an anti-tubercular regimen per the national guidelines. A detailed literature search revealed that no such case of primary isoniazid mono-resistant extrapulmonary tuberculosis presenting as cervical lymphadenitis has ever been reported.

“…Tuberculosis is a disease with a direct impact on the public health [ 1 ]. It is common in countries in Asia, Africa, and Europe [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Tuberculosis is a disease with a direct impact on the public health [ 1 ]. It is common in countries in Asia, Africa, and Europe [ 1 ]. Osteoarticular tuberculosis is a rare form of tuberculosis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis of Talonavicular Joint Without Pulmonary Involvement in an Indian Child: A Report of a Rare Case

Yadav¹,

Rawal²,

Jeyaraman³

2023

Self Cite

Osteoarticular tuberculosis is a rare entity, even in endemic countries. Isolated cases of tuberculosis of the talonavicular joint are sparse. Primary involvement of the talonavicular joint without pulmonary infection with Mycobacterium tuberculosis is rarest of rare. Here, we report a case of primary talonavicular joint tuberculosis without pulmonary involvement in an Indian child. To the best knowledge of the authors, it is the third such case ever reported in a child in the world. The patient presented with complaints of pain and swelling of the right foot. Detailed laboratory work-up backed by radiological investigations helped in establishing the diagnosis. He was managed conservatively with antitubercular chemotherapy with improvement in his symptoms and was transferred out to his native village.