Concomitant cutaneous metastatic tuberculous abscesses and multifocal skeletal tuberculosis

Area of Science:

• Pediatrics
• Infectious Diseases
• Dermatology

Background:

• Tuberculosis (TB), caused by Mycobacterium tuberculosis, commonly affects the lungs but can manifest in other organs.
• Metastatic cutaneous tuberculosis and skeletal tuberculosis (osteomyelitis) are rare extrapulmonary forms of the disease.
• Pediatric osteomyelitis due to TB is uncommon, often involving weight-bearing joints, with bilateral hand/foot involvement being exceptionally rare.

Purpose of the Study:

• To present a unique case of a pediatric patient with simultaneous, rare manifestations of tuberculosis.
• To highlight the diagnostic challenges and clinical significance of metastatic skin abscess and osteomyelitis in children.

Main Methods:

• Case report detailing the clinical presentation, diagnostic workup, and management of a five-year-old girl.
• Review of relevant literature on rare extrapulmonary tuberculosis presentations in pediatric populations.

Main Results:

• The patient presented with disseminated nodules and abscesses indicative of metastatic skin tuberculosis.
• Radiographic and clinical findings confirmed osteomyelitis, specifically affecting the bones of the hands and feet.
• The case illustrates simultaneous occurrence of two rare forms of extrapulmonary TB.

Conclusions:

• This case underscores the importance of considering tuberculosis in the differential diagnosis of pediatric skin abscesses and osteomyelitis, even with atypical presentations.
• Early recognition and appropriate treatment are crucial for managing rare and disseminated forms of Mycobacterium tuberculosis infection in children.