Multifocal tuberculosis presenting with osteoarticular and breast involvement.

Area of Science:

• Infectious Diseases
• Rheumatology
• Oncology

Background:

• Skeletal tuberculosis (TB) commonly affects the spine but can present with polyarticular involvement, including wrist and ankle arthritis, which are uncommon manifestations.
• Tuberculosis of the breast is an exceedingly rare condition, further complicating the diagnostic landscape.

Purpose of the Study:

• To report a rare case of simultaneous skeletal tuberculosis affecting the wrist and ankle, and tuberculosis of the breast in a single patient.
• To highlight the diagnostic challenges associated with atypical presentations of tuberculosis.

Main Methods:

• A case presentation detailing the diagnostic workup and microbiological confirmation of Mycobacterium tuberculosis.
• Involved biopsy and culture of both synovial fluid from affected joints and breast tissue.

Main Results:

• Confirmed Mycobacterium tuberculosis infection in both the synovial fluid from wrist and ankle joints and the breast biopsy specimen.
• Demonstrated the co-occurrence of disseminated skeletal tuberculosis and breast tuberculosis in one patient.

Conclusions:

• Tuberculosis arthritis is often a missed diagnosis due to its varied clinical presentations.
• A high index of suspicion is crucial for diagnosing tuberculosis, particularly in patients from high-risk populations or endemic areas.
• This case underscores the importance of considering tuberculosis in patients with unusual polyarticular arthritis and extrathoracic manifestations.