A Case of Extrapulmonary Tuberculosis

Abstract

A 21 years old man immigrant from Nigeria came to our observation for swelling of the chest wall and fever. The laboratory
tests showed neutrophilic leukocytosis and absence of HIV / others viruses’ infection. Chest X-ray was not conclusive. An abdomen
echography showed diffuse lymphadenopathy. In the suspicion ofa lymphoproliferative disease we performed a total body CT, that
detected colliquated lymph nodes in the later cervical, abdominal and pelvic stations; at the left pectoral region there was an abscess
collection (58x54mm) crossing the intercostal spaces until to the anterior pleura (Figure 1). Echocardiography showed mild
pericardial effusion. The thoracic abscess was drained and a sample of PCR for Mycobacterium tuberculosis was positive. We started
therapy with rifampicin, isoniazid, pyrazinamide, ethambutol and methyl prednisone, waiting for cultural examination The
patient was discharged in good clinical status with diagnosis of disseminated lymph node tuberculosis (LNTB) fistulized to the
chest wall abscess and he was referred to specialist follow-up.