Pseudotumoral form of soft tissue tuberculosis of the hand: six cases

Sbai, Mohamed Ali; Benzarti, Sofien; Chalbi, Emna; Msek, Hichem; Khorbi, Adel

doi:10.11604/pamj.2016.25.178.8918

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…20 Musculoskeletal TB of the hand region shows specific symptoms and signs such as painful and stiff joints, swelling joints with effusion, digital enlargement, and carpal tunnel syndrome. 18 In our case, the patient presented with suppuration, discoloration, and a painful mass on the 3 rd finger of the left hand. Initially, the patient was suspected of having a malignancy.…”

Section: Discussionmentioning

confidence: 69%

“…17 The infected cells in musculoskeletal tissue and mononuclear cells merge into epithelioid cells, called tubercles. 18 The diagnosis of musculoskeletal TB may need thorough investigation because it may present in atypical presentation (tumor-mimicking) and location. 19 Signs and symptoms of tuberculosis may vary from prolonged low-grade fever, weight loss, anorexia, and night sweats.…”

Section: Discussionmentioning

confidence: 99%

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Tuberculosis Mimicking-Musculoskeletal Tumor of The Hand: An Uncommon Case of Extrapulmonary Tuberculosis

Lesmana,

Dewanti,

Angin

et al. 2023

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Background: Musculoskeletal extrapulmonary tuberculosis is accounting for only 10-15% of all cases. Current attention has been focused on hand tuberculosis due to its increasing prevalence. This study describes an unusual case of extrapulmonary tuberculosis that manifested as a soft tissue tumor of the hand.Case Report: A 17-year-old male presented with a painful swollen part of the 3rd finger of the left hand. The mass was irregular and suppurative, with discoloration and foul smell. Laboratory results showed anemia and increased erythrocyte sedimentation rate. The computed tomography scan showed an isodense soft tissue (size 2.19 cm x 1.59 cm x 4.21cm) across the distal to the proximal part of 3rd phalanx bone to the metacarpal region with a decrease of phalanx bone density with no sign of bone destruction or any periosteal reaction. The histopathology study revealed a chronic granulomatous structure surrounded by epitheloid cells, datia Langhans cells, and caseating necrosis. The acid-fast staining confirmed the presence of bacilliform bacteria.Discussion: Extrapulmonary tuberculosis typically results from secondary hematogenous dissemination and reactivation of the main foci. There are no specific tests to diagnose musculoskeletal tuberculosis preoperatively, leading to delayed diagnosis. Histopathological examination and culture are needed to confirm the diagnosis.Conclusions: Slow progression and multiple differential diagnoses frequently result in a delayed diagnosis, which leads to complications. Initial radical excision and anti-tuberculosis multidrug therapy provide excellent functional outcomes and recurrence prevention.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Tuberculosis Mimicking-Musculoskeletal Tumor of The Hand: An Uncommon Case of Extrapulmonary Tuberculosis

Lesmana,

Dewanti,

Angin

et al. 2023

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Hand infections

Henry¹

2018

Current Orthopaedic Practice

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The integument provides only a limited barrier to protect the multiple functional structures of the hand from infection by common bacteria and other rare organisms. If infection is limited to just skin cellulitis, then antibiotics and careful monitoring may be all that is needed. Once bacteria become trapped in a deeper soft-tissue space and form an abscess then debridement must be performed to evacuate the purulence and necrotic tissue. Specialized compartments in the hand such as the pulp space, nail folds, joint cavities, and tendon sheaths facilitate bacterial containment and abscess formation, rendering immune response less effective. Osteomyelitis can originate from direct penetration or spread from an adjacent soft-tissue infection. Orthopaedic devices foster the development of a biofilm that can harbor bacteria, making resolution more difficult. The surgeon should obtain tissue for laboratory analysis at the deep infection site and subsequently administer empiric antibiotics while awaiting culture results. Greater duration of antibiotics is needed for infections of synovial tissues and bone. Unique infections caused by rare organisms may affect the hand, requiring recognition based on specific clinical features and confirmation by specialized laboratory testing.

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Isolated soft tissue tuberculosis: a case report and literature review

Chen,

Bao,

Chen

et al. 2023

Front. Med.

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Soft tissue tuberculosis is a rare extrapulmonary form of tuberculosis with limited experience in diagnosis and treatment. Soft tissue tuberculosis is an extrapulmonary infection with atypical clinical symptoms that can be easily misdiagnosed. In this article, we report a case of a female patient with isolated soft tissue tuberculosis who presented with a progressively enlarging subcutaneous mass as the primary symptom, and was suspected of having a subcutaneous lipoma after ultrasonography. A review of the literature revealed that soft tissue tuberculosis is insidious and mainly occurs in muscles and subcutaneous tissues. It was indicated by histopathology and qPCR testing for Mycobacterium tuberculosis complex. There is no standard treatment protocol for soft tissue tuberculosis, and a comprehensive regimen of surgical debridement of the lesion combined with chemotherapy can be used following the guidelines for treating extrapulmonary tuberculosis. Early diagnosis and standardized anti-tuberculosis treatment can significantly improve the prognosis of patients.

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Pseudotumoral form of soft tissue tuberculosis of the hand: six cases

Cited by 3 publications

References 9 publications

Tuberculosis Mimicking-Musculoskeletal Tumor of The Hand: An Uncommon Case of Extrapulmonary Tuberculosis

Tuberculosis Mimicking-Musculoskeletal Tumor of The Hand: An Uncommon Case of Extrapulmonary Tuberculosis

Hand infections

Isolated soft tissue tuberculosis: a case report and literature review

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