A Massive Tuberculosis Abscess at the Erector Spinae Muscles and Subcutaneous Tissues in a Young Man = خراج درني هائل في العضلات الناصبة للظهر و الأنسجة تحت الجلد عند رجل شاب

Abstract

Tuberculosis (TB) is a chronic granulomatous infection which can present in an atypical form. Isolated muscle involvement is very rare. We report a 25-year-old man who presented with a massive cystic swelling on the right side of his back, extending from the lower thoracic to the gluteal region. He had a history of contact with a friend who was suspected of having TB. Magnetic resonance imaging (MRI) showed that the origin of the cyst was from the erector spinae muscles. The result of a fluid aspirate showed acid fast bacilli. The swelling disappeared after treatment with anti-tuberculous medications. Muscular involvement in TB is very rare. In our patient, the reports of an ultrasound and MRI confirmed isolated muscle and subcutaneous involvement without bony lesions. This case is reported to increase physician awareness regarding soft tissue TB. Although it is rare, similar cases may be seen in the future.

Extrapulmonary tuberculosis presenting as a dumbbell tumour of the chest wall

“…Skeletal muscles are not known to get involved even in cases of disseminated tuberculosis (7) as skeletal muscle is considered to be an unfavorable site for the survival of mycobacteria reasoning out why this type of TB is rare (7,8,9). According to literature though rare, the skeletal muscles which were involved in the course of TB were the pelvic muscles, anterior abdominal wall muscles and paraspinal muscles where the infection was due to secondary spread from bone or joint infection (7,9,10). In such a background, the primary infection of the Latissimus dorsi muscle is an unusual form of tuberculosis.…”

Isolated Spontaneous Primary Tubercular Erector Spinae Abscess: A Case Report and Review of Literature

“…Erector spinae is deep skeletal muscle of back, and several reports [ 1 , 2 ] have described primary pyogenic erector spinae abscess along with extradural abscess. However, there has been only one report [ 3 ] of isolated spontaneous primary tubercular erector spinae abscess to date. The significance of this case report lies in the very fact that while evaluating a case of lower back pain, a physician should also consider isolated spontaneous tubercular abscesses in the differential diagnosis, particularly in endemic region where the incidence of musculoskeletal tuberculosis is very high.…”

Erector Spinae Tubercular Abscess

“…1. The authors state that until date, there has been only one report [ 2 ] on isolation of spontaneous primary tubercular erector spinae abscess [ 1 ]. We agree with the authors but we would like to draw attention towards one additional case report related with erector spinae tubercular abscess in a renal-transplant recipient [ 3 ].…”