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Unusual association of diseases/symptoms
Dermatomyositis masquerading musculoskeletal tuberculosis
  1. Sakthiswary Rajalingham1,
  2. Mohd Shahrir Mohd Said1,
  3. Syahrul Sazliyana Shaharir1,
  4. Aini AbAziz2,
  5. Petrick Periyasamy1,
  6. Fauzi Md Anshar1
  1. 1Department of Medicine, National University of Malaysia, Malaysia
  2. 2Department of Radiology, National University of Malaysia, Malaysia
  1. Correspondence to Dr Sakthiswary Rajalingham, sakthis5{at}hotmail.com

Summary

Dermatomyositis is a rare rheumatic disease which predominantly affects the muscles and skin requiring a protracted course of immunosuppressants which may predispose the patients to opportunistic infections. A 49-year-old lady was diagnosed to have dermatomyositis in August 2010 based on history, significantly raised creatine kinase level and muscle biopsy findings. She had recurrent admissions due to fever, myalgia and muscle weakness. She had spiking temperature despite high dose steroids, broad-spectrum antibiotics and antifungal agents. This prompted extensive investigation which leads us to the additional diagnosis of disseminated tuberculosis involving the lungs, muscles and bones. This case demonstrates the challenge in controlling the disease activity of dermatomyositis with immunosuppressants in the setting of disseminated tuberculosis.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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