Ben Abid Fatma, Abdel Rahman S Al Soub Hussam
Medicine, Infectious Disease Department, Hamad General Hospital-HMC, Hamad Medical Corp, Doha, Qatar.
Aging Male. 2020 Dec;23(5):411-414. doi: 10.1080/13685538.2018.1504915. Epub 2018 Oct 6.
Tuberculous mastitis (TBM) is relatively rare disease with an incidence ranging between 0.1 and 4%. Most of the cases are culture negative and often mistaken with chronic benign idiopathic granulomatous mastitis (IGM). It is very crucial to distinguish culture negative TBM from other causes of mastitis as the treatment differs tremendously. We describe here in a young woman originally from India and residing in Qatar; a non endemic area of tuberculosis; for more then fifteen years. She presented with 2 months history of right breast mass, followed by low grade fever, dry cough, headache, erythema nodosum, arthritis, and arthralgia. In view of the origin of the patient, positive family history for tuberculosis and positive quantiferon, the patient was started empirically on anti-tuberculous treatment (ATT). One week later she developed paradoxical reaction to ATT. This case illustrates unusual and rare manifestations of primary TBM and highlights the importance of differentiating and treating culture negative TBM from IGM.
结核性乳腺炎（TBM）是一种相对罕见的疾病，发病率在0.1%至4%之间。大多数病例培养结果为阴性，常被误诊为慢性良性特发性肉芽肿性乳腺炎（IGM）。由于治疗方法差异极大，将培养阴性的TBM与其他乳腺炎病因区分开来至关重要。我们在此描述一名年轻女性，她原籍印度，在卡塔尔（结核病非流行地区）居住了十五年多。她出现右乳肿块2个月病史，随后伴有低热、干咳、头痛、结节性红斑、关节炎和关节痛。鉴于患者的籍贯、结核病家族史阳性以及结核菌素试验阳性，患者开始接受经验性抗结核治疗（ATT）。一周后，她出现了对ATT的矛盾反应。该病例说明了原发性TBM的不寻常和罕见表现，并强调了将培养阴性的TBM与IGM区分开来并进行治疗的重要性。
