Case report 654: Disseminated tuberculosis

A case of disseminated tuberculosis with a psoas abscess and associated destruction of bone in a 28-year-old man has been presented. Multiple skeletal lesions and hilar adenopathy were observed. The initial diagnosis from pathological specimens was equivocal, since acid-fast bacilli were not demonstrated. However, special stains of biopsy specimens subsequently confirmed the diagnosis. The initial radiographs suggested disseminated malignancy. Good therapeutic results were obtained, utilizing surgical and chemotherapeutic methods. This case demonstrates the ability of disseminated tuberculosis to mimic other disease processes and shows the difficulty that may exist in establishing a diagnosis of tuberculosis, even with biopsy specimens.