An unusual presentation of tuberculosis

Abstract

A young Somali gentleman presented to the Emergency Department with unrelated symptoms and was noted to have a large, soft pre-sternal mass. He denied cough, night sweats, lethargy or fever but on closer inspection was noted to be malnourished and had pale conjunctivae. The lump was drained and the fluid was sent to culture and sensitivity and microscopy. Lateral chest x-ray revealed a soft tissue pre-sternal mass. A CT scan was done and revealed a cavitating lesion in the left upper lobe. A diagnosis of Tuberculosis was done and he was started on standard therapy; Isoniazid, Rifampicin, Ethambutol and Pyrazinamide. The patient was discharged from hospital and was followed up at outpatients with a specialist TB respiratory physician.