Tuberculosis infection of the ischium in a patient with poorly controlled diabetes mellitus: A case report

Abstract

Primary tuberculosis infection of the ischium is rare and challenging, particularly in immunocompromised patients. We present the case of a 74-year-old man with poorly controlled diabetes mellitus who developed persistent pain and swelling, even the sinus discharged from the left gluteal fold region. Imaging studies revealed lytic lesions in the ischium, cortical destruction, and soft tissue involvement. Histopathological examination confirmed that caseous necrosis occurred. The patient was initiated appropriate treatment for tuberculosis infection, and his symptoms improved without disease progression. Primary tuberculosis infection poses significant diagnostic challenges due to overlapping clinical and radiological features. Early recognition and a multidisciplinary approach involving infectious disease specialists, pulmonologists, radiologists, and surgeons are crucial for optimal management. The prognosis of this infection is poor, emphasizing the importance of timely diagnosis and treatment. To improve outcomes, comprehensive screening and early detection of infections in high-risk patients, such as those with uncontrolled diabetes, are essential. Future advancements in diagnostic tools may facilitate prompt and accurate diagnosis. Clinicians should maintain a high index of suspicion and employ appropriate diagnostic techniques to ensure early identification and effective management of these complex infections.