Tuberculosis (TB) involving the musculoskeletal system is unusual. An acute and multifocal noncontiguous presentation is diagnostically challenging as it simulates various other infections, hematological malignancies, and secondaries. In this study, we report a rare record of a 14-year-old girl who presented with multiple focal swellings on her body within a short duration of 6 days. The tuberculin skin test was exaggerated and the cartridge-based nucleic acid amplification test (CBNAAT) of the granulomatous aspirate revealed rifampicin-resistant TB. Magnetic resonance imaging (MRI) showed swellings with underlying bone erosions and cultures of pus aspirate from the right shoulder region turned out to be Rifampicin and Isoniazid resistant TB.
Yilmaz MH, Kantarci F, Mihmanli I, et al. Multifocal skeletal tuberculosis. South Med J 2004;97(8):785–787. DOI: 10.1097/00007611-200408000-00023
Moon MS, Moon YW, Moon JL, et al. Conservative treatment of tuberculosis of the lumbar and lumbosacral spine. Clin Orthop Relat Res 2002;398:40–49. DOI: 10.1097/00003086-200205000-00007
Amin MU, Shafique M, Mahmood R, et al. Multifocal osseous tuberculosis involving hands and feet. J Coll Physicians Surg Pak 2008;18(4):244–245.
Grosskopf I, Ben David A, Charach G, et al. Bone and joint tuberculosis—a 10-year review. Isr J Med Sci 1994;30(4):278–283.
Rasool MN. Osseous manifestations of tuberculosis in children. J Paediatr Orthop 2001;21(6):741–755.
Hosalkar HS, Agrawal N, Reddy S, et al. Skeletal tuberculosis in children in the Western world: 18 new cases with a review of the literature. J Child Orthop 2009;3(4):319–324. DOI: 10.1007/s11832-009-0184-7
Malik S, Joshi S, Tank JS. Cystic bone tuberculosis in children –a case series. Indian J Tuberc 2009;56(4):220–224.
Dhammi IK, Jain AK, Singh S, Aggarwal A, Kumar S. Multifocal skeletal tuberculosis in children: a retrospective study of 18 cases. Scand J Infect Dis 2003;35(11–12):797–799. DOI: 10.1080/00365540310017177
Dewan M, Tandon A, Rohatgi S, et al. Multifocal tuberculous osteomyelitis in a 3-year-old child. Paediatr Int Child Health 2017;37(2):152–154. DOI: 10.1080/20469047.2016.1154285
Hazra A, Laha B. Chemotherapy of osteoarticular tuberculosis. Indian J Pharmacol 2005;37(1):5–12. DOI: 10.4103/0253-7613.13847
Gyanshankar PM, Dhamgaye TM, Amol FB. Spina ventosa discharging tubercle bacilli-a case report. Indian J Tuberc 2009;56(2):100–103.