title: Tuberculosis mimicking primary systemic vasculitis: not to be missed!
abstract: Infections are an important differential diagnosis in patients presenting with features of systemic vasculitis. We report a young lady with constitutional features, leg ulcers, digital gangrene and absent peripheral pulses with cervical adenopathy. Chest imaging revealed multiple necrotic lung lesions and involvement of left subclavian artery at its origin from the aorta, Histopathology from cervical lymph nodes showed multiple caseated lymph nodes, which in the context of a positive Mantoux test led us to diagnose tuberculosis and institute appropriate therapy. This is only the second report of tuberculosis presenting as peripheral gangrene, cutaneous ulcers and absent pulses, and serves to educate rheumatologists regarding the need to consider infections as mimics of vasculitis, especially in the developing countries.
authors.affiliation: 1 Senior Resident, Department of Clinical Immunology, JIPMER, Puducherry, India.
authors.forename: Ankit
authors.initials: A
authors.lastname: Jain
authors.affiliation: 2 Assistant Professor, Department of Clinical Immunology, JIPMER, Puducherry, India.
authors.forename: Durga Prasanna
authors.initials: DP
authors.lastname: Misra
authors.affiliation: 3 Associate Professor, Department of Radiodiagnosis, JIPMER, Puducherry, India.
authors.forename: A
authors.initials: A
authors.lastname: Ramesh
authors.affiliation: 4 Professor, Department of Pathology, JIPMER, Puducherry, India.
authors.forename: Debdatta
authors.initials: D
authors.lastname: Basu
authors.affiliation: 2 Assistant Professor, Department of Clinical Immunology, JIPMER, Puducherry, India.
authors.forename: Vikramraj K
authors.initials: VK
authors.lastname: Jain
authors.affiliation: 5 Professor and Head, Department of Clinical Immunology, JIPMER, Puducherry, India.
authors.forename: Vir Singh
authors.initials: VS
authors.lastname: Negi
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005734:Gangrene / Q000175:diagnosis; D006801:Humans; D056647:Systemic Vasculitis / Q000175:diagnosis*; D014376:Tuberculosis / Q000175:diagnosis*; D014456:Ulcer / Q000175:diagnosis
keywords: Tuberculosis; gangrene; large vessel vasculitis; medium vessel vasculitis; pulse loss; ulcer