Bézy Coline, Noirhomme Séverine, Montigny Pierre, Abouhamad Pierre, Jouret Francois, Georges Benoît
Service de Médecine interne générale-Néphrologie, CHRSM, Namur, Belgique.
Service de Médecine interne générale-Infectiologie, CHRSM, Namur, Belgique.
Rev Med Liege. 2023 Mar;78(3):165-172.
Tuberculosis is one of the deadliest infectious disease. Its annual incidence was 10 million cases in 2019. We report the case of a 40 years old immunocompetent patient presenting with two large subcutaneous masses in his back. The diagnosis work-up will reveal multifocal tuberculosis with pulmmonary, vertebral, muscular and lymph node lesions. This case is unusual due to its presentation in an immunocompetent patient. Several laboratories have conducted experiments to isolate characteristics of the host that would allow the infection to spread despite the absence of an immunosuppressive medical condition. We also analyze the role of the PET scanner in the initial assessment and its interest in the monitoring of extra-pulmonary disease under anti-tuberculosis treatment. Multifocal tuberculosis cases are no longer the preserve of the immunocompromised and can be found in our industrialized countries. We must enonciate this diagnosis in front of unusual presentations. The delay in consultation, but also the delay of treatment, allows more widespread infections.
