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Abstract
We report this case of a 15-year-old male who presented to the children outpatient clinic (CHOP) of Abia State University Teaching Hospital (ABSUTH), Aba on the 5th of November 2015. He had tuberculosis (TB) of the skin (scrofuloderma) which was not diagnosed and had received treatment other than anti-TB medication. He now presented 9 years after with multiple body discharging sinuses, cicatricial skin lesions, tuberculosis of the spine (L5, S1) with contracture of the Achilles Tendon and genital warts. Subsequent treatment with full anti-TB drugs led to resolution of his illness. A higher index of suspicion is required for early diagnosis of extrapulmonary TB. Prompt and adequate treatment with anti-TB medication ensures cure in such cases. Appropriate control program is also known to improve the outcome and reduce sequelae.
Highlights
We report this case of a 15-year-old male who presented to the children outpatient clinic (CHOP) of Abia State University Teaching Hospital (ABSUTH), Aba on the 5th of November 2015
To the best of our knowledge, this is the first case of extrapulmonary TB showing association between scrofuloderma and TB of the lower spine with a viral infection of the penile shaft/scrotal sac in a teenager at ABSUTH, and in Abia State of Nigeria
The index patient, a 15-year-old male first presented at ABSUTH on the 5th of November 2015, with a 9 years history of multiple wounds, discharging pus, which was first noticed on the Armpit, on the legs and thighs
Summary
Extra Pulmonary Tuberculosis (EPTB) is seen in patients with tuberculosis of organs other than the lungs e.g. pleura, lymph nodes, abdomen, genitourinary tracts, skin, joint, bone and meninges. Of the 2610 cases of childhood TB in a study from Abidjan, 77.24% were pulmonary while 22.76% were extrapulmonary [5]. Caseous pus may track along muscles causing psoas abscess especially, with T12 or lumbar vertebrae involvement [7]. We hereby present a case of a 15-year-old boy who was not detected to have had pulmonary tuberculosis, nor received anti-TB treatment, until he came to us after 9 years of sinus discharge of pus from different areas of his body. To the best of our knowledge, this is the first case of extrapulmonary TB showing association between scrofuloderma and TB of the lower spine with a viral infection of the penile shaft/scrotal sac in a teenager at ABSUTH, and in Abia State of Nigeria
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