<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec><h3>Introduction</h3>
<p>Tuberculosis (TB) can be located in any segment of the osteoarticular system, being the most common in the spine, with approximately 50% of cases. In only 10% of the cases of osteoarticular TB the location is multiple; generally, it is monoarticular or located at the level of a single segment of the spine. The diagnosis can be delayed in the early stages due to its varied and hidden presentation and the probability of being confused with other pathologies of the osteoarticular system. Delay in diagnosis can lead to chronic pain, joint destruction and progression to symptomatic bony ankylosis.</p>
</sec>
<sec><h3>Case Presentation</h3>
<p>A 64-year-old man presented with left lower limb, coccyx pain and peri-anal discharge. CT scan of the pelvis showed recto-integumentary perianal fistulous trajectory externalised on the left side of the anus and osteomyelitis. Left ankle CT: Cystic image of approximately 4.2/6/10 cm well-demarcated, with some central microcalcifications, located in the postero-tibial soft parts, communicating with the tibiotalar joint.</p>
</sec>
<sec><h3>Conclusion</h3>
<p>This case highlights the importance of considering TB as a diagnosis if unusual sites are involved.</p>
</sec>
</abstract>

Introduction
Tuberculosis (TB) can be located in any segment of the osteoarticular system, being the most common in the spine, with approximately 50% of cases. In only 10% of the cases of osteoarticular TB the location is multiple; generally, it is monoarticular or located at the level of a single segment of the spine. The diagnosis can be delayed in the early stages due to its varied and hidden presentation and the probability of being confused with other pathologies of the osteoarticular system. Delay in diagnosis can lead to chronic pain, joint destruction and progression to symptomatic bony ankylosis.

Case Presentation
A 64-year-old man presented with left lower limb, coccyx pain and peri-anal discharge. CT scan of the pelvis showed recto-integumentary perianal fistulous trajectory externalised on the left side of the anus and osteomyelitis. Left ankle CT: Cystic image of approximately 4.2/6/10 cm well-demarcated, with some central microcalcifications, located in the postero-tibial soft parts, communicating with the tibiotalar joint.

Conclusion
This case highlights the importance of considering TB as a diagnosis if unusual sites are involved.

Coexistence of multiple forms of tuberculosis – a delayed diagnosis

Department of Pulmonology, Center for Research and Innovation in Precision Medicine of Respiratory Diseases

“Victor Babes” University of Medicine and Pharmacy Timisoara

Pneumologia

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

{"article-title":"Coexistence of multiple forms of tuberculosis \u2013 a delayed diagnosis"}

Introduction
Tuberculosis (TB) can be located in any segment of the osteoarticular system, being the most common in the spine, with approximately 50% of cases....

Coexistence of multiple forms of tuberculosis – a delayed diagnosis

Publicado en línea: 17 oct 2023

Páginas: 76 - 80

DOI: https://doi.org/10.2478/pneum-2023-0024

Palabras clave
osteoarticular tuberculosis, multiple locations, cold abscess, perianal fistulas

© 2022 Militaru Laura Amalia et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Coexistence of multiple forms of tuberculosis – a delayed diagnosis

Publicado en línea: 17 oct 2023

Páginas: 76 - 80

DOI: https://doi.org/10.2478/pneum-2023-0024

Palabras claveosteoarticular tuberculosis, multiple locations, cold abscess, perianal fistulas

© 2022 Militaru Laura Amalia et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Palabras clave
osteoarticular tuberculosis, multiple locations, cold abscess, perianal fistulas