Extrapulmonary tuberculosis: importance of differential diagnosis.
Patients with tuberculosis (TB) typically present with pulmonary TB, but extrapulmonary TB is also an important clinical problem. In particular, osteoarticular TB has a great morbidity and its diagnosis gold-standard includes culture and histopathology of the infected area. The present case study describes a 53-year-old female Portuguese farmer who had initial clinical and imaging features suggestive of tuberculous osteomyelitis. However, she denied any TB contacts and the tuberculin skin-test and interferon-γ release assay result were negative. Brucella melitensis was isolated from a tissue biopsy cultural examination, and treatment for brucellosis was started, yielding a favourable outcome. In similar circumstances, a precise diagnosis, that considers the epidemiological context, is crucially important for adequate treatment and reduction of morbidity.
Pulmonology Department, Centro Hospitalar de São João, Porto, Portugal. patmota@net.sapo.pt
Patrícia Caetano
PC
Mota
David
D
Sá
Margarida
M
Mota
Raquel
R
Duarte
D001706:Biopsy; D002006:Brucellosis / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000382:microbiology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013902:Radiography, Thoracic; D013122:Spinal Diseases / Q000175:diagnosis* / Q000382:microbiology*; D014374:Tuberculin Test
D003287:Contrast Media