A rare presentation of multifocal tuberculosis in an immunocompetent patient

Introduction: Multifocal tuberculosis (MT) is an uncommon presentation in immunocompetent patients. It’s associated more with immune-depression like Human Immunodeficiency Virus infection. We report a case of MT presternal cold abscess, mediastina and cervical adenopathy, bone, vertebral location that occurred apparently patient. Case presentation: A 19-year old woman no previous history (TB) exposure was admitted for chronic chest pain lasting 13 months. She presented fever, night sweat weight loss (09 kg). The first clinical examination noticed voluminous abscess. X-Ray showed enlargement the middle mediastinum to pleural effusion opacity, but any active pulmonary lesions. computed tomography revealed presence parietal mass centered on sternum, extension soft parts, bone lies sternal manubrium, hemi-bodies T10 T11, lymph nodes, phrenic sub-pectoral nodes peritoneal mesenteric involvement. Magnetic resonance imaging spine tiered thoracic lumbar sacral spondylitis paravertebral anterior epidural collections responsible spinal cord compression next D10 without signs pain. draining abscess some whitish pus, which acid-alcohol resistant bacilli were identified. There diabetes, renal failure, or long-term treatment corticosteroids immunosuppressant’s: HIV serology viral hepatitis negative. blood glucose normal. patient treated anti-tuberculosis regimen based on: Ethambutol, Rifampicin, Isoniazid, Pyrazinamide two months, then rifampicin isoniazid seven outcome good disappearance all radiological signs. Conclusion: TB such as reported are confined mostly immunocompromised patients especially those Because polymorphic features multifocal TB, diagnosis usually difficult make, resulting into delay before beginning adequate treatment.