A Rare Case of Tubercular Breast Abscess in a Young Immunocompetent Non-Lactating Female

Shalini Malhotra Manju Kaushal

doi:10.4172/2327-5073.1000190

Abstract

Tuberculosis (TB) is a major public health problem in India accounting for one-fourth of the global incident TB cases annually and associated with high morbidity and mortality if not treated adequately. However, breast tuberculosis is a very rare entity with an incidence between 0.1%-3% of all breast diseases, and approximately 4% incidence among breast diseases in TB endemic countries. Here we are reporting a rare case of primary tubercular abscess in the subareolar region of right breast of a young non-lactating female that initially presented with a painful lump and non-specific symptoms. Ultrasound breast suggested breast abscess and diagnosis of tuberculosis was made by FNAC (Fine Needle Aspiration Cytology) and ZN Staining (Ziehl Neelson Staining) of the pus which was confirmed on culture. Patient was started on anti-tubercular therapy and responded well on follow up.

Highlights

In India, tuberculosis (TB) is a major public health problem accounting for one-fourth of the global incident TB cases annually and associated with high morbidity and mortality if not treated adequately
High index of suspicion is required for its diagnosis and Fine Needle Aspiration Cytology (FNAC) or biopsy is required for definitive diagnosis
We are reporting a case of primary tubercular abscess in the right breast of a young female that was initially diagnosed as a case of breast abscess and was later identified as tubercular breast abscess

Summary

Introduction

In India, tuberculosis (TB) is a major public health problem accounting for one-fourth of the global incident TB cases annually and associated with high morbidity and mortality if not treated adequately. Breast tuberculosis is a very rare entity with an incidence between 0.1%-3% of all breast diseases, and approximately 4% incidence among breast diseases in TB endemic countries [3] It mostly affects young lactating women and it is often misdiagnosed as an abscess or carcinoma breast. The patient was average built, afebrile, and with normal vitals She was married two years back and was planning to conceive since 6 months. There was no growth of any pyogenic organism after 48 hrs of incubation but ZN stain was positive for acid fast bacilli suggestive of tubercular abscess (Figure 1). The present case was a young non-lactating female presenting with non-specific complaints like pain in breast, loss of appetite, weight loss and intermittent fever and was diagnosed as a case of breast abscess by ultrasound breast and advised for FNAC. As soon as the diagnosis of tubercular breast abscess made, patient was put to Category I ATT and patient responded well to treatment during follow up

Discussion

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Conclusion