DISSEMINATED TB IN AN IMMUNOCOMPETENT PATIENT

TYPE: Case Report TOPIC: Chest Infections INTRODUCTION: Disseminated tuberculosis (TB) is a rare presentation, more common in patients with HIV, chronic liver disease or alcohol abuse and associated high rates of treatment failure. CASE PRESENTATION: A 28 years-old male, history asthma, started complains cough, sputum production asthenia . Despite inhaled steroids, he continued to deteriorate. Skin ulcerations on the right wrist, elbow leg appeared 4 months later. Fourteen after first symptoms, there was purulent drainage ulcers knee edema which prevented patient from walking. The presented hospital extreme weight loss (20Kg). HIV screening negative. CT scan peri broncho-vascular opacities, tree-in-bud, cavitary lesions pneumomediastinum. PCR for Mycobacterium positive pus. antibiotics (Clindamycin) anti-TB drugs. drain placed knee. Bone MRI revealed osteomyelitis knee, femur cervical-dorsal spine, need surgical cleaning. DISCUSSION: long evolution symptoms probably responsible exuberant presentation this case disseminated TB. strategies treat skin were very challenging due different microbiologic isolates recurrence drainage. extension bone led arm movement impairment. Due this, multidisciplinary evaluation decision perform surgery essential prevent permanent disability. CONCLUSIONS: This highlights challenges management thoracic complications lesions, cutaneous ulceration DISCLOSURE: Nothing declare. KEYWORD: