PMID- 30975973
OWN - NLM
STAT- MEDLINE
DCOM- 20191203
LR  - 20200225
IS  - 1941-5923 (Electronic)
IS  - 1941-5923 (Linking)
VI  - 20
DP  - 2019 Apr 12
TI  - Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic 
      Tuberculosis Abscess.
PG  - 503-507
LID - 10.12659/AJCR.913615 [doi]
AB  - BACKGROUND Multifocal tuberculosis (TB) with more than 1 tuberculous 
      osteoarticular lesion is rare. Furthermore, metastatic tuberculous abscess (MTA) 
      is also a very rare manifestation of cutaneous TB in children. A non-specific, 
      often subtle, early clinical presentation in conjunction with a low prevalence 
      rate constitute obstacles for diagnosis. CASE REPORT A 9-years old female patient 
      was referred to Hasan Sadikin Pediatric Respirology Outpatient clinic from the 
      Orthopedic Department with lumps at the left elbow joint, lateral side of the 
      left hand, and lateral side of the left foot. Fine needle aspiration biopsy of 
      the lumps suggested a chronic inflammation due to TB. The patient was then 
      started with a course of anti-TB drugs consisting of rifampicin, isoniazid, 
      pyrazinamide, and ethambutol. During the treatment course, she experienced 
      anti-TB drug-induced hepatotoxicity (ADIH). We then switched the regimen to 
      streptomycin and ethambutol for 2 weeks, then reintroduced treatment with the 
      modified British Thoracic Society guidelines regimen. The nodules appeared 
      shrunken after 3 months of treatment with anti-TB drugs. CONCLUSIONS Increased 
      awareness of unusual manifestations of TB will likely allow for proper diagnosis 
      and management of this common infection. Accordingly, timely diagnosis and 
      management will prevent further debilitating sequelae.
FAU - Nataprawira, Heda Melinda
AU  - Nataprawira HM
AD  - Department of Child Health, Universitas Padjadjaran - Hasan Sadikin General 
      Hospital, Bandung, West Java, Indonesia.
FAU - Ediwan, Natasha A
AU  - Ediwan NA
AD  - Department of Child Health, Universitas Padjadjaran - Hasan Sadikin General 
      Hospital, Bandung, West Java, Indonesia.
FAU - Diana, Inne Arline
AU  - Diana IA
AD  - Department of Dermato-Venerology, Universitas Padjadjaran - Hasan Sadikin General 
      Hospital, Bandung, West Java, Indonesia.
FAU - Dwiyana, Reiva Farah
AU  - Dwiyana RF
AD  - Department of Dermato-Venerology, Universitas Padjadjaran - Hasan Sadikin General 
      Hospital, Bandung, West Java, Indonesia.
FAU - Febrina, Dia
AU  - Febrina D
AD  - Department of Dermato-Venerology, Universitas Padjadjaran - Hasan Sadikin General 
      Hospital, Bandung, West Java, Indonesia.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20190412
PL  - United States
TA  - Am J Case Rep
JT  - The American journal of case reports
JID - 101489566
SB  - IM
MH  - Abscess/*microbiology
MH  - Child
MH  - Female
MH  - Humans
MH  - Metacarpal Bones/diagnostic imaging/microbiology
MH  - Osteomyelitis/*microbiology
MH  - Radiography
MH  - Tuberculosis, Osteoarticular/*diagnosis
MH  - Tuberculosis, Pulmonary/diagnostic imaging
MH  - Ulna/diagnostic imaging/microbiology
PMC - PMC6474155
COIS- Conflict of interest: None declared Conflicts of interest None.
EDAT- 2019/04/13 06:00
MHDA- 2019/12/04 06:00
PMCR- 2019/04/12
CRDT- 2019/04/13 06:00
PHST- 2019/04/13 06:00 [entrez]
PHST- 2019/04/13 06:00 [pubmed]
PHST- 2019/12/04 06:00 [medline]
PHST- 2019/04/12 00:00 [pmc-release]
AID - 913615 [pii]
AID - 10.12659/AJCR.913615 [doi]
PST - epublish
SO  - Am J Case Rep. 2019 Apr 12;20:503-507. doi: 10.12659/AJCR.913615.