[Multifocal tuberculosis of bone. Apropos of an exceptional case]

Multifocal tuberculosis of bones (MTB) is exceptional in Europe. To the few cases found in the literature the authors add another case well documented by computerized tomography and nuclear magnetic resonance and remarkable for the number of bone lesions and their coexistence with extra-skeletal lesions. The patient was a 28-year old man native of the Ivory Coast in whom the imaging techniques demonstrated no less than 19 different bone lesions plus an abscess of the iliopsoas muscle and a prevertebral pus collection. The diagnosis of MTB was confirmed by the finding of alcohol- and acid-fast bacilli at needle aspiration of the bone lesions and by the presence of folliculo-caseous Ziehl-stained granuloma on bronchial biopsies. Fourteen months after treatment with specific 4-drug therapy, the outcome is favourable. This case is exceptional by the diffusion of bone lesions and by their association with bronchial lesions due to lymph node fistulization. Modern imaging techniques (CT, NMR), clearly demonstrated the bone lesions and their extent.