Tuberculosis (TB) commonly presents in the pulmonary form, but extrapulmonary TB may also be seen in any part of the body. This report presents a case of extrapulmonary TB in a 21-year-old male patient who immigrated from Africa. He presented with a painful chest wall swelling that appeared suddenly and had no other symptoms. CT of the chest, abdomen, and pelvis showed fluid collections of the chest wall and mesentery that were drained and biopsied. PCR of the drainage detected Mycobacterium tuberculosis (Mtb) DNA, and AFB culture with smear grew Mtb. This patient’s sudden onset of chest wall swelling in the absence of other symptoms presents as an unusual presentation of TB not generally seen in high-income countries where TB prevalence is low. This case exemplifies the importance of maintaining a high suspicion for extrapulmonary TB, especially in patients from endemic countries.
Yi et al. (Wed,) studied this question.