Metastatic Cutaneous Abscesses as Initial Presentation of Tuberculosis in an Immunocompetent Patient

Metastatic tuberculous abscesses are a rare but clinically significant manifestation of tuberculosis. Cutaneous tuberculosis accounts for just 1%-2% of extrapulmonary cases, with cold abscesses being one possible skin manifestation. Skin lesions are most commonly acquired through hematogenous dissemination from distant foci of infection, particularly in immunocompromised individuals. We describe an unusual case of disseminated tuberculosis in a young, immunocompetent adult, initially presenting with cutaneous abscesses and weight loss, with an absence of typical TB symptoms. The patient was treated and closely followed by the county TB program. This case underscores the importance of considering tuberculosis in the differential diagnosis of widespread abscesses, even in immunocompetent patients, and highlights that pulmonary symptoms may be absent despite extensive pulmonary disease.