[A case of abdominal tuberculosis relapsed after resection]

Abdominal wall tuberculosis is rare. We report a case of abdominal wall tuberculosis that relapsed after surgery. A 40-year-old man without a past history of tuberculosis visited our hospital complaining of an abdominal wall mass. The mass was resected in the department of orthopedics of our hospital. No bacteriological or histological examination of the resected specimen was done. After 5 months, the patient found swelling of the axillary lymph node. CT revealed left axillary lymph node swelling and chest wall nodules of various sizes. As the pus aspirated from the left axillary lymph node was positive for PCR-TB, the patient was diagnosed with relapsed chest wall tuberculosis and tuberculous lymphadenopathy. Antituberculosis drugs (isoniazid, rifampicin, ethambutol and pyrazinamide) were administered, but resistance to both isoniazid and ethambutol were revealed afterward. So, isoniazid and ethambutol were replaced with levofloxacin and streptomycin. After 6 months of this therapy, the left axillary lymph node decreased remarkably and became scarred. Abdominal tuberculosis should be considered in cases of an abdominal wall mass, regardless of whether the patient has a history of tuberculosis. This case stresses the importance of postoperative anti-tuberculosis treatment, as well as the need for bacteriological and histological examinations of resected specimens.