Article Text

Download PDFPDF
Reminder of important clinical lesson
Extrapulmonary tuberculosis: importance of differential diagnosis
  1. Patrícia Caetano Mota1,
  2. David Sá2,
  3. Margarida Mota3,
  4. Raquel Duarte4,5,6
  1. 1Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal
  2. 2Orthopaedics Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  3. 3Infectious Diseases Unit–Internal Medicine Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  4. 4Pulmonology Department, Centro de Diagnóstico Pneumológico de Vila Nova de Gaia, Vila Nova de Gaia, Portugal
  5. 5Pulmonology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  6. 6Hygiene and Epidemiology Department, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
  1. Correspondence to Dr Patrícia Caetano Mota Dr, patmota{at}net.sapo.pt

Summary

Patients with tuberculosis (TB) typically present with pulmonary TB, but extrapulmonary TB is also an important clinical problem. In particular, osteoarticular TB has a great morbidity and its diagnosis gold-standard includes culture and histopathology of the infected area. The present case study describes a 53-year-old female Portuguese farmer who had initial clinical and imaging features suggestive of tuberculous osteomyelitis. However, she denied any TB contacts and the tuberculin skin-test and interferon-γ release assay result were negative. Brucella melitensis was isolated from a tissue biopsy cultural examination, and treatment for brucellosis was started, yielding a favourable outcome. In similar circumstances, a precise diagnosis, that considers the epidemiological context, is crucially important for adequate treatment and reduction of morbidity.

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.