[Lymph node and cutaneous tuberculosis revealed by a pyloroduodenal stenosis: a case report]

Lymphadenitis is the most frequent form of extrapulmonary tuberculosis. In immunocompetent patients, its clinical presentation is usually superficial, less frequently intra-abdominal located, and exceptionnally symptomatic. We report a case of scrofuloderma characterized by the lymph nodes extent of spread which led to a pyloro-duodenal stenosis. An 18 years old immunocompetend man is admitted in the internal medicine department, presenting a pyloroduodenal stenosis syndrome, fever, weight loss, and ulcerated axillary and cervical lymph nodes. The upper gastrointestinal endoscopy and ultrasound examination reveal the extrinsic duodenal compression by large numerous lymph node. A biopsy confirms the tuberculosis disease for which no other localisation was detected. Despite of the diagnostic and therapeutic delay, which explains the expanse and depth of the lesions, the antituberculosis therapy was effective on the digestive symptom and cleared all the cutaneous manifestations.