A Case of Musculoskeletal Tuberculosis Mimicking Adult-Onset Still's Disease.
- Author:
Jin Kyeong CHO
1
;
Min Sung KIM
;
Jin Ho SHIN
;
Yeon Sang JEONG
;
Joon Wan KIM
;
Jae Phil CHOI
;
Byoong Yong CHOI
Author Information
1. Department of Internal Medicine, Seoul Medical Center, Seoul, Korea. atom9752@hanmail.net
- Publication Type:Case Report
- Keywords:
Fever of unknown origin;
Mycobacterium tuberculosis;
Osteoarticular;
Still's disease;
Adult-onset
- MeSH:
Abscess;
Arthralgia;
Biopsy;
Diagnosis, Differential;
Exanthema;
Ferritins;
Fever of Unknown Origin;
Humans;
Leukocytosis;
Liver Function Tests;
Middle Aged;
Mycobacterium tuberculosis;
Necrosis;
Polymerase Chain Reaction;
Spine;
Still's Disease, Adult-Onset*;
Tuberculosis*
- From:Korean Journal of Medicine
2014;86(6):785-790
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 46-year-old man was admitted to our hospital because of a fever of unknown origin. The patient had a skin rash, arthralgia, and hepatosplenomegaly. Laboratory tests showed leukemoid leukocytosis, a high serum ferritin level (31,200 ng/mL), and abnormal liver function tests. He was initially diagnosed with adult-onset Still's disease (AOSD). However, imaging studies incidentally detected a cold abscess involving the 11th thoracic vertebra. A biopsy of the abscess revealed histologically granulomatous caseous necrosis, positive for M. tuberculosis by polymerase chain reaction. We present a patient with musculoskeletal tuberculosis (TB) that clinically mimicked AOSD. In TB-endemic countries, extrapulmonary TB should be included in the differential diagnosis of AOSD.
