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Multifocal musculoskeletal tuberculosis mimicking multiple bone metastases: a case report
Meiping Ye1,2, Jinwei Huang3, Jie Wang4
1Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China. yemeiping1988@163.com.
BMC Infectious Diseases
|January 30, 2016
Summary
Multifocal musculoskeletal tuberculosis can mimic bone metastases, leading to delayed diagnosis. Early consideration of tuberculosis is crucial for accurate diagnosis and timely treatment of these rare cases.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Multifocal musculoskeletal tuberculosis is a rare condition.
- Its presentation can mimic metastatic bone disease, complicating diagnosis.
- This case highlights diagnostic challenges in rare tuberculous spondylitis.
Observation:
- A 63-year-old male presented with 10 months of multifocal pain.
- Initial investigations including imaging (CT, MRI, PET-CT) and biopsies suggested bone metastases.
- T-SPOT results were negative, further supporting a misdiagnosis.
Findings:
- A subcutaneous swelling ulcerated, revealing positive acid-fast bacilli smear and TB-DNA PCR.
- This led to the correct diagnosis of multifocal musculoskeletal tuberculosis.
- The patient was initially misdiagnosed for 8 months.
Implications:
- Accurate diagnosis of musculoskeletal tuberculosis is challenging due to atypical presentations and Mycobacterium tuberculosis variants.
- Multiple tuberculous spondylitis should be included in the differential diagnosis for multiple musculoskeletal lesions.
- This case underscores the importance of considering tuberculosis in complex musculoskeletal presentations.
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