Tuberculous Fasciitis in Polymyositis: A Rare Case of Extrapulmonary Tuberculosis

A 71-year-old woman with polymyositis presenting with left thigh pain and an intermittent fever was admitted to Osaka Rosai Hospital. We initially diagnosed that her pain and fever were caused by a soft tissue infection because her polymyositis was controlled. She did not respond to various antibiot...

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Bibliographic Details
Published in:Internal Medicine 2016/11/01, Vol.55(21), pp.3205-3209
Main Authors: Nagayama, Ikue, Nagatoya, Katsuyuki, Kurahara, Yu, Mega, Akira, Morita, Masashi, Haga, Ryota, Yamanouchi, Yu, Yamaguchi, Yoshito, Oka, Tatsufumi, Yamauchi, Atsushi
Format: Article
Language:English
Subjects:
Aged
Case Report
Diagnosis, Differential
Fasciitis - complications
Fasciitis - diagnosis
Female
Fever - etiology
Humans
Immunocompromised Host
Mycobacterium
Pain - etiology
polymyositis
Polymyositis - complications
Polymyositis - diagnosis
Thigh
Tomography, X-Ray Computed
Tuberculosis, Miliary - complications
Tuberculosis, Miliary - diagnosis
Tuberculosis, Miliary - diagnostic imaging
tuberculous fasciitis
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Summary:A 71-year-old woman with polymyositis presenting with left thigh pain and an intermittent fever was admitted to Osaka Rosai Hospital. We initially diagnosed that her pain and fever were caused by a soft tissue infection because her polymyositis was controlled. She did not respond to various antibiotic therapies. Chest computed tomography demonstrated miliary tuberculosis (TB). Ziehl-Neelsen staining of liver biopsy specimens revealed epithelioid cell granuloma and acid-fast bacilli. Therefore, we finally diagnosed the lesion as TB fasciitis that improved with anti-TB drug therapy. The atypical presentation of TB fasciitis demonstrates the clinical importance of eliminating TB infections in immunocompromised hosts.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.5548