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Related Experiment Videos

Multi focal tuberculosis.

T S S Lakshmi1, A Gnaneshwar Rao

  • 1Department of Dermatology, Osmania General Hospital, Hyderabad-500 012, India.

Indian Journal of Dermatology, Venereology and Leprology
|July 28, 2007
PubMed
Summary
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Tuberculosis can manifest in the hands, causing bone lesions and swelling. Early diagnosis and antituberculosis treatment led to clinical improvement in a young salesman.

Area of Science:

  • Medical Microbiology
  • Radiology
  • Orthopedics

Background:

  • Tuberculosis (TB) is a significant global health issue, primarily affecting the lungs.
  • Skeletal tuberculosis, though less common, can present with diverse and sometimes atypical clinical manifestations.
  • Disseminated tuberculosis can involve multiple organ systems, including bones and soft tissues.

Purpose of the Study:

  • To report a rare case of tuberculous gumma presenting with osteolytic lesions and pathological fractures in the hands.
  • To highlight the importance of considering tuberculosis in the differential diagnosis of hand swellings and bone lesions.
  • To illustrate the diagnostic process and successful treatment outcome.

Main Methods:

  • Clinical presentation of a 19-year-old male with hand swellings and sinuses.

Related Experiment Videos

  • Radiographic evaluation including chest X-ray and hand X-rays.
  • Microbiological confirmation of Mycobacterium tuberculosis using Lowenstein Jensen medium culture.
  • Initiation of standard antituberculosis treatment.

    • Main Results:

    • The patient presented with multiple fusiform swellings and sinuses on the hands and elbow.
    • X-rays revealed apical lung cavities, infiltration, osteolytic lesions, and pathological fractures in both hands.
    • Acid-fast bacilli (AFB) were successfully cultured, confirming tuberculosis.
    • Antituberculosis treatment resulted in significant clinical improvement.

    Conclusions:

    • Tuberculous gumma can present as a rare cause of destructive bone lesions in the hands.
    • A high index of suspicion and appropriate diagnostic workup are crucial for managing skeletal tuberculosis.
    • Prompt antituberculosis therapy is effective in achieving favorable outcomes even in complex presentations.