Abdominal and cervical lymphadenopathy and multiple abscesses due to mycobacterium tuberculosis; A case report

Background: Mycobacterium tuberculosis is the cause of 43% of the peripheral lymphadenopathy cases in developing countries. However, psoas abscesses are usually secondary to the extension of infection from an adjacent site. In the present study, we describe a case of abdominal and cervical lymphadenopathy and multiple abscesses due to mycobacterium tuberculosis. Patient: A 55 years old man with abdominal and cervical lymphadenopathy, psoas muscle sheath abscess and a large abscess of abdominal wall was admitted. Vertebral column was intact and the patient didn’t have immunodeficiency or history of illicit drug use. Analysis of aspirated pus with PCR for mycobacterium tuberculosis was positive, however, Ziehl-Neelsen and gram staining was negative. Culture of pus was positive for mycobacterium. Treatment was commenced with 4 drug antituberculosis regimen. During the treatment period, paradoxical reaction occurred and prednisolone was administered. Following 9 months of treatment, the abscesses resolved and the patient recovered completely. Conclusion: our patient presented with a group of uncommon extrapulmonary presentations including GI involvement, paraaortic lymphadenopathy and abscess formation secondary to tuberculosis that was aroused without any immunodeficiency context with hematogenous origin. He responded well to our therapeutic protocol.