Tuberculosis of Muscle

Katz, Robert I.; Herman, Monte A.; Katz, Sol

doi:10.1001/jama.1964.03070180070020

Cited by 9 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tuberculous myositis has been recognized for a long time, with one of the first reported cases published by Riverdin et al in 1891. The rarity of this condition was highlighted by studies in the early 20th century: Culota, in 1923, found only 4 cases among 2224 autopsies in cases of tuberculosis (0.18%), whereas Petter, in 1934, reported only 1 case among 6000 patients with tuberculosis 54 . This led to various hypotheses to explain the resistance of muscle to infection by M. tuberculosis ; including high lactic acid levels, low oxygen concentrations, lack of macrophages, and the differentiated nature of muscle cells.…”

Section: Discussionmentioning

confidence: 99%

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

et al. 2020

View full text Add to dashboard Cite

M ycobacterium tuberculosis infects approximately 1.7 billion people in the world and causes disease in 10 million annually. Musculoskeletal tuberculosis accounts for 2% to 5% of cases, generally presenting as Pott's spine or large joint arthritis 1 ; the involvement of muscle by tubercle bacilli, referred to as tuberculous myositis, is rare. Muscle involvement can occur either due to hematogenous spread (primary) or as a result of extension from a contiguous site (secondary); the former being less common. 2 We report a case of primary tuberculous myositis and review all cases published in the last 25 years. CASE REPORTA 49-year-old man was admitted with swelling and dullaching pain over the right gluteal region, fever, and loss of appetite for 6 months. Three years prior to the current presentation, he had been diagnosed with dermatomyositis and treated with corticosteroids and azathioprine; these drugs were tapered and stopped after 2 years. With a possibility of relapse, corticosteroids were restarted 1 month before his admission.On examination, a localized tender swelling was present over the right gluteal area and posterior thigh, extending to the knee. Magnetic resonance imaging of this region revealed active myositis of the gluteal muscle and muscles in the posterior compartment of the right thigh (Figs. 1A, B). Positron emission tomographycomputed tomography showed uptake in these muscles, and an image-guided biopsy was performed. This revealed granulomatous inflammation on histopathology (Fig. 2), and a cartridge-based nucleic acid amplification test GeneXpert MTB/RIF (Cepheid, Sunnyvale, CA) detected M. tuberculosis. Computed tomography of the thorax did not show any pulmonary tuberculosis; however, tuberculin skin test was positive. Antitubercular therapy was started with isoniazid, rifampicin, ethambutol, and pyrazinamide for 2 months, followed by isoniazid, rifampicin, and ethambutol for 8 months. The fever resolved within 2 weeks, and over the next few months, the swelling subsided, and the patient gained weight. At 1 year, he was found to be asymptomatic and disease-free. METHODS FOR SYSTEMATIC REVIEWWe carried out a search in PubMed (MEDLINE), Scopus, EMBASE, and Web of Science, using the words "tubercular myositis," "tubercular pyomyositis," "tuberculous myositis," or "tuberculous pyomyositis." This review was restricted to articles in English language that were published between January 1995 and December 2019. Abstracts and full texts of relevant articles were examined by 2 authors (H.S., V.D.), and those articles that described cases of primary tuberculous myositis confirmed by microbiological tests (or on histopathology) were included for review. The outcome of cases was noted, factors associated with death analyzed, and odds ratios (ORs) (95% confidence intervals [CIs]) calculated. Analysis was done by GraphPad Prism (version 8 for Windows, La Jolla, CA).

show abstract

Section: Discussionmentioning

confidence: 99%

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Tubercular involvement of the muscles has been postulated to be the result of haematogenous dissemination of tubercular lesions on lungs [ 4 , 12 ], contagious transmission from an underlying structure like tuberculosis of the bones, tubercular arthritis and synovial lining [ 4 ], or without evidence of active foci of tuberculosis elsewhere in the body or osseous involvement [ 3 ] and direct traumatic inoculation [ 4 ]. The presence of multiple swellings in different parts of the body with normal examination of bone and no evidence of bone involvement in radiography makes the possibility of contagious transmission from an underlying structure less likely in this patient.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis presenting as multiple intramuscular nodules in a child: a case report

Dhakal¹,

Shah²,

Shrestha³

et al. 2015

J Med Case Reports

View full text Add to dashboard Cite

IntroductionTuberculosis is a global health problem that mostly affects people in developing countries. Tuberculosis can occur in various organ systems and may present with diverse manifestations in the same system. Primary muscular tuberculosis is a very rare condition in both adults and children, and tuberculosis of various muscle groups presenting as intramuscular nodules is an even more uncommon presentation.Case presentationA 9-year-old Asian girl presented with multiple painless, gradually progressive swellings over different parts of her body for 3 months with no history of contact with tuberculosis. A physical examination was normal except for multiple swellings in her right forearm, a single swelling in her interscapular region and multiple swellings in her right calf. Ultrasonography of swellings revealed multiple nodules in the intramuscular layer. Excisional biopsies performed from two different sites revealed swellings in muscular layers and histopathology showed granulomatous inflammation with caseous necrosis consistent with tuberculosis. The child was started on antitubercular therapy after which the swellings resolved; she was kept on regular follow up.ConclusionsIntramuscular nodules in multiple muscular sites may be the presenting symptoms of tuberculosis of the muscles. Tuberculosis of skeletal muscles should be considered in a differential diagnosis when presented with single or multiple masses even when a chest X-ray is normal and there is no evidence of tubercular foci elsewhere in the body.

show abstract

“…The term primary tuberculous myositis is used to describe the clinical condition, in which the predominant lesion in the event of hematogenous TB occurs in the muscle. Hematogenous dissemination of the tubercle bacillus to the muscle has been described in a few cases and is, therefore, exceptionally rare 3 .…”

Section: Introductionmentioning

confidence: 99%

Chest wall soft-tissue tuberculosis: A case report

Álvarez-Moran¹,

Ávila-Sánchez

Fernández-Lara³

2020

HGMX

View full text Add to dashboard Cite

Chest wall tuberculosis (TB) is a rare condition, making up 1-5% of all musculoskeletal TB cases. We report a case of a 39-year-old woman with a palpable mass on the right hemithorax with a 3-month evolution. The computed tomography scan showed a mass of 4 cm above the pectoralis major muscle. Complete removal of the tumor was performed, which showed caseous material with positive polymerase chain reaction for Mycobacterium tuberculosis. The patient has not presented any symptoms 6 months after a quadruple-based therapy. We emphasize the fact of suspecting this pathology, when soft-tissue masses are found on the chest wall, due to its rare localization.

show abstract

Tuberculosis of Muscle

Cited by 9 publications

References 0 publications

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

Primary Tuberculous Myositis—Report of a Case and Systematic Review of Literature in the Last 25 Years

Tuberculosis presenting as multiple intramuscular nodules in a child: a case report

Chest wall soft-tissue tuberculosis: A case report

Contact Info

Product

Resources

About