[Tuberculous gumma or metastatic tuberculous abscess as initial diagnosis of tuberculosis in an immunocompetent patient: an unusual presentation].

BACKGROUND AND OBJECTIVES Tuberculous cold abscesses or gumma are an unusual form of tuberculosis. We report a case of gumma as initial diagnosis of disseminated tuberculosis. METHOD This case was studied in 2012 in Barcelona ( Spain). Source data was compiled from the electronic clinical records, hospital reports and additional diagnostic testing. RESULTS Immunocompetent inmate, born in Cape Verde, living in Spain since the age of four. Positive tuberculin skin test. Initial examination without interest, but a palpable mass in lower back. Fine needle aspiration of the abscess was positive (PCR and Lowenstein) for M. tuberculosis. Computed tomography showed lung cavitary nodes in apical part and lung upper right side. After respiratory isolation, antituberculous therapy and an excellent evolution, the patient was discharged from hospital with disseminated tuberculosis diagnosis. DISCUSSION It is advisable to monitor the injuries since, although rare, it may be secondary to Mycobacterium tuberculosis infection, mainly in inmuno-compromised populations and in immigrants coming from hyper-endemic tuberculosis areas.