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Unusual and rare cases of tuberculosis in immunocompetent patients

Sunita Dinkar, Srajan Dashore, Sapna Desai, Sonal Agrawal.




Abstract
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Introduction: Tuberculosis is a major health issue across the world. Extraperitoneal manifestations of tuberculosis have a varied presentation masquerading with other common pathologies. Though it is widespread, diagnosing tuberculosis at unusual sites forms a challenge even in the hands of experienced because of the variance and atypical presentations of tuberculosis at these sites, no standard diagnostic definitions and difficult accessibility of tissue samples.

Case series: We report a case series of very rare cases of tuberculosis at unusual sites,
treated at our hospital. The period of follow-up ranged from 3 months to one and a half years. All the patients included in this series show signs of improvement at follow-up.

Conclusion: High index of suspicion is required to diagnose tuberculosis at unusual sites even in endemic countries. This helps in getting investigations done in the right direction without delay. While CBNAAT and culture are the gold standards for diagnosing M. Tuberculosis, histopathological examination, ADA, CT scan along clinical features can help in correct diagnosis and timely treatment. Reporting of such unusual and rare cases forms a key source of information on research in tuberculosis and collectively make the base for optimization of diagnostic criteria for early detection and treatment.


Key words: Extrapulmonary tuberculosis, splenic tuberculosis, testicular tuberculosis, breast tuberculosis, tuberculous breast mastitis, ocular tuberculosis






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