title: A case of tuberculous pyomyositis that caused a recurrent soft tissue lesion localized at the forearm.
abstract: We present the case of a 20-year-old male who had a non-traumatic soft tissue lesion (4 x 3 cm) with recurrent discharge at his right posteromedial antebrachial muscles; the patient underwent surgery twice, and antibiotic therapy was administered, but no cure was achieved with these treatments. The patient underwent surgery at our medical center. There was no history of pulmonary, gastrointestinal, or genitourinary tuberculosis (TB). Due to suspected pulmonary, genitourinary, and gastrointestinal TB, radiography and computed tomography scans were performed, and these studies disclosed no evidence of a primary origin. The erythrocyte sedimentation rate and the results of purified protein derivate testing were normal. We also detected submandibular lymphadenopathy (LAP) (2 x 3 cm) localized at a submandibular site in our patient 4 months after his first visit to our clinic. Smears were stained with Ehrlich Ziehl Neelsen (EZN) stain and culture were grown for Mycobacterium tuberculosis complex (MTC); the samples used for these assays had been obtained by incisional biopsy of the forearm lesion and by aspiration of the submandibular lymph node, and they were found to be MTC-positive. Then, a culture for MTC, derived from an induced sputum sample, was found to be positive, despite the negative results obtained with a sputum smear subjected to EZN staining. According to these results, the primary focus of the tuberculous pyomyositis and the submandibular LAP was the lungs. The lesion and submandibular LAP were both treated successfully by the administration of antituberculous chemotherapy.
authors.affiliation: Department of Microbiology and Clinical Microbiology, Gulhane Military Medical Academy School of Medicine, Ankara, Turkey. obaylan@gata.edu.tr
authors.forename: Orhan
authors.initials: O
authors.lastname: Baylan
authors.forename: Bahtiyar
authors.initials: B
authors.lastname: Demiralp
authors.forename: Engin Ilker
authors.initials: EI
authors.lastname: Cicek
authors.forename: Ali
authors.initials: A
authors.lastname: Albay
authors.forename: Mahmut
authors.initials: M
authors.lastname: Komurcu
authors.forename: Ozgul
authors.initials: O
authors.lastname: Kisa
authors.forename: Armagan
authors.initials: A
authors.lastname: Gunal
authors.forename: Mehmet Sahin
authors.initials: MS
authors.lastname: Ugurel
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D005542:Forearm / Q000382:microbiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D018461:Soft Tissue Infections / Q000382:microbiology* / Q000473:pathology*; D014382:Tuberculosis, Cutaneous / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery; D014388:Tuberculosis, Lymph Node / Q000150:complications / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents