Disseminated Tuberculosis with Involvement of Appendix, Peritoneum and Right Knee Joint - A Case Report

Authors

  • Mohammad Syedul Islam Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka
  • Md. Abul Kalam Azad BSMMU, Dhaka
  • Hanif Mohammad MMC
  • Mohammad Mushahidul Islam MMCH
  • Md. Abdur Rahim BSMMU

DOI:

https://doi.org/10.3329/jom.v15i2.20702

Keywords:

Disseminated Tuberculosis, Appendicular lump, Arthritis

Abstract

A 27 year old male presented with painful swelling of right knee joint for the last 6 months. Initially it was diagnosed as a case of reactive arthritis and was treated with NSAID with intraarticular steroids without significant improvement. Two months after the initial episode he again developed painful swelling of the right knee joint with severe abdominal pain and high grade fever. There was an ill defined ovoid mass in the right iliac fossa with generalized tenderness. ESR was raised and the ultrasonography revealed loculated ascites with appendicular lump. CT scan of the whole abdomen showed appendicular lump. FNAC from the lump showed tuberculosis. Joint fluid aspiration showed neutrophilic leucocytosis with the Total count 50,000/cmm. AFB was not found. So septic arthritis was  diagnosed, but as the patient was not improving we send the patient to orthopedic department for synovial biopsy but they refused as it was septic. So a diagnosis of disseminated Tuberculosis was made with the involvement of right knee joint, appendix and peritoneum. He was put on anti TB and well responded.

DOI: http://dx.doi.org/10.3329/jom.v15i2.20702

J MEDICINE 2014; 15 : 153-155

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Author Biographies

Mohammad Syedul Islam, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka

Research Assistant, Department of Medicine

Md. Abul Kalam Azad, BSMMU, Dhaka

Associate Professor, Department of Medicine

Hanif Mohammad, MMC

Associate Professor, Department of Medicine

Mohammad Mushahidul Islam, MMCH

Junior Consultant Medicine

Md. Abdur Rahim, BSMMU

Professor, Department of Medicine

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Published

2014-10-21

How to Cite

Islam, M. S., Azad, M. A. K., Mohammad, H., Islam, M. M., & Rahim, M. A. (2014). Disseminated Tuberculosis with Involvement of Appendix, Peritoneum and Right Knee Joint - A Case Report. Journal of Medicine, 15(2), 153–155. https://doi.org/10.3329/jom.v15i2.20702

Issue

Section

Case Reports