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Tuberculosis infection in patients with dermatomyositis
Luis Carlos Palomino Romero1, Alfredo Vargas Caselles1, Natalia Soledad Rius1
1Rheumatology Section, Internal Medicine Department, Italian Hospital of Buenos Aires.
Reumatismo
|March 11, 2025
Summary
Dermatomyositis patients are prone to infections. Three cases developed tuberculous myositis, presenting diagnostic challenges due to overlapping symptoms with the underlying inflammatory condition.
Area of Science:
- Infectious Diseases
- Rheumatology
- Immunology
Background:
- Patients with dermatomyositis (DM) experience immunosuppression from the disease and its treatments.
- This immunosuppression increases susceptibility to opportunistic infections.
- Tuberculosis (TB) can manifest in muscles, mimicking inflammatory myopathy symptoms.
Purpose of the Study:
- To describe cases of tuberculous myositis in patients diagnosed with dermatomyositis.
- To highlight the diagnostic challenges posed by TB superinfection in DM.
- To emphasize the importance of considering TB in the differential diagnosis of DM exacerbations.
Main Methods:
- Case series describing three patients with DM and tuberculous myositis.
- Diagnostic methods included polymerase chain reaction (PCR) for Mycobacterium tuberculosis and Ziehl-Neelsen staining.
- Muscle biopsy and bronchoalveolar lavage were utilized for sample collection.
Main Results:
- Three patients with DM were diagnosed with tuberculous myositis.
- Mycobacterium tuberculosis was detected via PCR in a post-mortem muscle biopsy in one case.
- Ziehl-Neelsen stain and PCR confirmed TB in bronchoalveolar lavage and tissue samples in other cases.
Conclusions:
- Tuberculous myositis can occur in patients with dermatomyositis.
- Symptoms of TB superinfection can resemble dermatomyositis, complicating diagnosis.
- Differential diagnosis is crucial for appropriate management of opportunistic infections in DM patients.
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