Wembulua Shinga Bruce, Ndiaye Maodo, Badiane Aboubakar Sidikh, Belem Arielle Rita, Andriateloasy Solohery, Aïssatou Lakhe Ndeye, Dièye Alassane, Cisse Diallo Viviane Marie Pierre, Diallo Mbaye Khardiata, Ka Daye, Déguénonvo Louise Fortes, Seydi Moussa
Service des maladies infectieuses et tropicales, Centre hospitalier national universitaire de Fann, Dakar, Sénégal.
Service de dermatologie et vénérologie, Centre hospitalier national universitaire Aristide Le Dantec, Dakar, Sénégal.
Ann Biol Clin (Paris). 2020 Apr 1;78(2):177-180. doi: 10.1684/abc.2020.1537.
The breast tuberculosis accounts for 0.06 to 0.1% of extra-pulmonary localizations. Frequent in women, it remains exceptional in men. We report a rare case of primary breast tuberculosis occurring in a male patient. A 33-years-old patient presented with a chronic and fistulized non-inflammatory-right breast swelling with an atrophic cutaneous ulceration. The thoracic CT was in favor of a right breast abscess with a thick wall. The patient had received non-specific antibiotics (amoxicillin-clavulanate and metronidazole) for 10 days coupled with a surgical drainage before consulting us for persisting symptoms. The culture of the pus was sterile, the GeneXpert and the search for acid-fast bacilli (AFB) both performed on the swab of the ulceration were negative. Histopathological analysis of the lesion was in favor of a granulomatous mastitis. Given the chronic and atrophic nature of the ulceration, the histological aspect of granulomatous mastitis and the persisting symptoms despite the non-specific antibiotic therapy, we made a presumptive diagnostic of breast tuberculosis. The evolution was favorable with oral anti-tuberculosis treatment.
乳腺结核占肺外结核定位的0.06%至0.1%。在女性中较为常见，在男性中仍属罕见。我们报告一例男性患者发生的原发性乳腺结核罕见病例。一名33岁患者出现慢性、瘘管化的非炎性右乳房肿胀，伴有萎缩性皮肤溃疡。胸部CT显示右乳房脓肿，壁增厚。患者在因症状持续前来我们处就诊之前，已接受非特异性抗生素（阿莫西林 - 克拉维酸和甲硝唑）治疗10天，并进行了外科引流。脓液培养无菌，在溃疡拭子上进行的GeneXpert检测和抗酸杆菌（AFB）检测均为阴性。病变的组织病理学分析支持肉芽肿性乳腺炎。鉴于溃疡的慢性和萎缩性性质、肉芽肿性乳腺炎的组织学表现以及尽管进行了非特异性抗生素治疗但症状仍持续存在，我们做出了乳腺结核的推定诊断。口服抗结核治疗后病情好转。
