Fatal tuberculous myositis in an immunocompromised adult with primary Sjögren's syndrome.
Tuberculous myositis, which mimics rheumatic symptoms, is an extremely rare disease. Clinical ambiguity easily leads to misdiagnosis and delayed initial treatment. We present the case of a 55-year-old man who had primary Sjögren's syndrome and active cutaneous vasculitis treated with steroid and immunosuppressive drugs. He presented with a swollen, painful, hot left thigh. Although anti-tuberculosis medications were administered soon after a positive acid-fast stain of incisional muscular tissue, he died of rapidly progressive tuberculous myositis and multiorgan failure following 18 days of hospitalization. This case is presented to increase the awareness of this rare entity in clinical practice.
Huang
Chi-Chang
CC
Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Liu
Ming-Fei
MF
Lee
Nan-Yao
NY
Chang
Chia-Ming
CM
Lee
Hsin-Chun
HC
Wu
Chi-Jung
CJ
Ko
Wen-Chien
WC
D001706:Biopsy; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000382:microbiology / Q000473:pathology*; D009220:Myositis / Q000209:etiology* / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications* / Q000175:diagnosis; D014376:Tuberculosis / Q000209:etiology* / Q000473:pathology