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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
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated