Tuberculous gluteal abscess coexisting with scrofuloderma and tubercular lymphadenitis

Area of Science:

• Dermatology
• Infectious Diseases
• Microbiology

Background:

• Tuberculosis (TB) typically affects the lungs, but extrapulmonary manifestations can occur.
• Cutaneous tuberculosis is uncommon, presenting diverse clinical features.
• Differential diagnosis of buttock swelling with skin lesions includes various infectious and inflammatory conditions.

Observation:

• A 23-year-old male presented with left buttock swelling, skin lesions, and seropurulent discharge.
• Initial investigations, including smears for bacteria, fungi, and acid-fast bacilli (AFB), were negative.
• Skin biopsy culture ultimately identified Mycobacterium tuberculosis.

Findings:

• Skin and lymph node biopsies revealed granulomatous inflammation consistent with tuberculosis.
• The patient had no prior history of tuberculosis.
• Diagnosis was confirmed by positive culture for Mycobacterium tuberculosis from skin biopsy.

Implications:

• This case highlights the importance of considering tuberculosis in the differential diagnosis of unusual skin lesions, even without a history of the disease.
• Early diagnosis and appropriate antitubercular therapy are crucial for favorable outcomes in cutaneous tuberculosis.
• Further research into the pathogenesis and diagnostic challenges of extrapulmonary TB is warranted.