Unusual cervicofacial localization of two subcutaneous tuberculous cold abscesses in an immunocompetent subject

Subcutaneous tuberculous cold abscesses represent a rare form of extra-pulmonary tuberculosis and their cervicofacial localization is exceptional. The management of this unusual form and location is medico-surgical and must be adapted to avoid progression to complications.

We report the case of a double cervicofacial localization of subcutaneous tuberculous cold abscesses in an immunocompetent patient followed for pulmonary tuberculosis who benefited from a surgical drainage of the two abscesses with anti-tuberculosis treatment with good clinical evolution.

The diagnosis of subcutaneous tuberculous cold abscesses is based on a combination of anamnestic, clinical and paraclinical findings. Cold abscesses are most commonly described in patients with disseminated tuberculosis or during human immunodeficiency virus infection, but they may also occur in immunocompetent subjects. Monofocal localization is the most common and the association of several localizations is unusual. The treatment is medical-surgical, combining surgical drainage with anti-tuberculosis treatment.

Subcutaneous tuberculous cold abscesses should be considered in the presence of any stubborn collection occurring in a context of tuberculosis infection. Early diagnosis is the best guarantee of a cure without complications.