Tuberculous Paraspinal Abscess Invading Esophagus: A Rare Cause of Dysphagia

Esophageal involvement by mycobacterium tuberculosis is a rare entity even in the endemic regions. The common presenting complaint in esophageal tuberculosis are deglutition disorders in which patients primarily present with difficulty in swallowing. The most common site of esophageal involvement is the middle-third at the level of carina. Herein, the case of an adolescent boy is presented who had complains of dysphagia, abdominal pain along with weight loss for a month. On evaluation, he was found to have esophageal narrowing resulting in dysphagia. CT scan revealed a fistulous communication of tuberculous paraspinal abscess with the esophagus, which had resulted in dysphagia. The diagnosis of tuberculosis was made by using gold standard method of Polymerase Chain Reaction (PCR) of mycobacterium tuberculosis. He had marked symptomatic improvement within a month of starting anti tuberculous therapy (ATT) and was successfully treated with ATT for 9 months.