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Tuberculous pyomyositis: a re-emerging entity of many faces.
[pyomyositis]
Tuberculosis
(
TB
)
has
become
a
global
concern
due
to
its
increasing
incidence
,
particularly
in
immunocompromised
patients
,
closely
following
the
migratory
patterns
of
populations
.
TB
pyomyositis
is
a
rare
extrapulmonary
manifestation
of
TB
.
Its
clinical
presentation
varies
and
requires
a
high
degree
of
suspicion
for
early
diagnosis
.
We
present
three
patients
diagnosed
with
TB
pyomyositis
:
a
46
-
year
-old
man
with
dermatomyositis
(
DM
)
and
hepatitis
B
who
presented
with
fever
,
muscle
weakness
,
and
an
abscess
at
the
right
proximal
arm
;
a
71
-
year
-old
immunocompetent
male
,
with
a
past
medical
history
of
tuberculous
lymphadenopathy
in
childhood
,
who
presented
with
a
2
-
month
history
of
fever
and
pain
at
the
right
thigh
,
and
a
44
-
year
-old
woman
with
systemic
lupus
erythematosus
(
SLE
)
on
prednisone
and
methotrexate
who
presented
with
skin
eruption
at
her
thighs
mimicking
lupus
panniculitis
.
In
all
three
patients
,
Mycobacterium
tuberculosis
was
identified
as
the
causative
agent
.
The
lack
of
specific
signs
,
the
false
negative
tuberculin
skin
test
in
some
cases
,
and
the
unfamiliarity
of
many
clinicians
with
this
entity
can
cause
diagnostic
delays
.
Prompt
diagnosis
requires
a
high
index
of
suspicion
especially
in
immunocompromised
patients
with
fever
.
Diseases
Validation
Diseases presenting
"hepatitis"
symptom
benign recurrent intrahepatic cholestasis
cholangiocarcinoma
congenital toxoplasmosis
dracunculiasis
esophageal squamous cell carcinoma
hirschsprung disease
inclusion body myositis
legionellosis
neuralgic amyotrophy
papillon-lefèvre syndrome
primary effusion lymphoma
pyomyositis
scrub typhus
severe combined immunodeficiency
typhoid
waldenström macroglobulinemia
This symptom has already been validated