Microbiologically Confirmed Primary Tubercular Breast Abscess in a Young Female: A Case Report

Tuberculosis rarely affects the breast. This report presents a case of a microbiologically confirmed primary tubercular breast abscess in a young Ethiopian woman. A 26-year-old woman presented with left breast swelling and pain for 1 year. She was initially suspected to have a pyogenic abscess of the breast and was treated with unspecified oral antibiotics but had no clinical response. In addition, surgical drainage was done, followed by a 4-week course of oral amoxicillin-clavulanic acid. However, the swelling gradually increased in size and formed a sinus tract with a purulent discharge. Subsequently, breast tuberculosis was suspected, and a GeneXpert from the discharge was performed, which revealed rifampicin-sensitive Mycobacterium tuberculosis. She was started on anti-tuberculous medications and showed significant clinical response after 6 months of therapy. Breast tuberculosis should be considered earlier in patients with breast lesions in the absence of an alternative diagnosis and/or if the response to antibiotics is not as expected. In this case, histopathology from the breast lesion and cartridge-based nucleic acid amplification test (GeneXpert) from the breast discharge were confirmatory for breast tuberculosis.