A case with multisystemic involved of Tuberculosis

Area of Science:

• Infectious Diseases
• Immunology
• Radiology

Background:

• Tuberculosis (TB) typically affects the lungs but can manifest in multiple organs, particularly in immunocompromised individuals.
• Multisystemic TB in immunocompetent adults is uncommon and challenging to diagnose due to varied presentations.
• Early and accurate diagnosis is crucial for effective management and preventing disease progression.

Observation:

• An 18-year-old male presented with diplopia, a hand digit wound, and swelling.
• Clinical examination revealed signs suggestive of disseminated disease.
• Imaging and biopsy confirmed tuberculous involvement across multiple sites.

Findings:

• The patient was diagnosed with multisystemic tuberculosis involving orbital bone, soft tissues, spine (spondylitis), hand digit (dactylitis), skin (scrofuloderma), and lungs.
• This case demonstrates a rare presentation of extensive TB in an immunocompetent young adult.
• The diverse clinical manifestations mimicked other disorders, complicating the initial diagnosis.

Implications:

• This case underscores the importance of considering tuberculosis in the differential diagnosis of multisystemic disorders, even in immunocompetent patients.
• Highlights the diagnostic challenges posed by atypical TB presentations.
• Emphasizes the need for comprehensive investigations to identify all affected sites in suspected multisystemic TB.