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Left Middle Phalanx Tuberculous Dactylitis Masquerading as a Tumor: First Case Report in Saudi Arabia
Houriah Yasir Nukaly1,2, Ruqayyah Ali Ahmed1,2, Ahmed Hafez Mousa1,2
1From the College of Medicine and Surgery, Batterjee Medical College, Jeddah, Saudi Arabia.
Plastic and Reconstructive Surgery. Global Open
|September 17, 2024
Summary
Tuberculous dactylitis, a rare form of tuberculosis affecting the fingers, can mimic tumors. Early diagnosis and combined surgical and anti-tuberculosis treatment are vital for positive patient outcomes.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Tuberculous dactylitis is an uncommon extrapulmonary manifestation of tuberculosis.
- It often presents nonspecifically, leading to misdiagnosis as neoplasms or other conditions.
Observation:
- A 15-year-old male presented with a year of finger pain and swelling after an injury.
- Initial assessments suggested Staphylococcus infection, but imaging revealed extensive bone and soft tissue abnormalities.
- Biopsy findings of granulomatous inflammation led to tuberculosis confirmation via Quantiferon TB Gold Test.
Findings:
- Magnetic resonance imaging showed medullary expansion and soft tissue swelling, mimicking a tumor.
- Histopathology revealed necrotizing and suppurative granulomatous inflammation.
- Quantiferon TB Gold Test confirmed latent tuberculosis infection.
Implications:
- This case underscores the importance of considering tuberculosis in dactylitis, even with atypical presentations.
- Prompt diagnosis and a combination of surgical intervention and antitubercular therapy are crucial for effective management.
- Highlighting the need for increased awareness among clinicians to avoid diagnostic delays in tuberculous dactylitis.
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