A rare encounter: Tuberculous pyomyositis in an immunosuppressed post-transplant patient

Tuberculous pyomyositis is an uncommon form of extrapulmonary tuberculosis (EPTB). We report a rare case of EPTB in a 34-year-old male post-renal transplant recipient. He presented with pain in the left hip region and fever 9 years after the renal transplantation. A tender swelling was noted over the left hip region, visualized as a loculated hyperintense lesion on MRI. Ultrasound-guided aspiration revealed a purulent discharge which showed acid-fast bacilli on Ziehl-Neelsen staining. GeneXpert MTB confirmed the presence of Mycobacterium tuberculosis, sensitive to Rifampicin. The patient was diagnosed with tuberculous pyomyositis. Antitubercular treatment (ATT) was started and the abscess was drained.