Multifocal Tuberculosis- an unusual encounter

Abstract

Multifocal tuberculosis is a rare clinical condition which presents with an indolent and atypical clinical course, leading to a delayed diagnosis along with significant bone and joint destruction. A high index of clinical suspicion along with radiological imaging and confirmation with sample testing from a proper site is required for its diagnosis. We present a case of atypical disseminated multifocal tuberculosis involving the base of skull, posterior spine, ilium, sacroiliac joint and rib that presented with atypical clinical symptoms to a neurosurgeon. Imaging findings were uncommon, more suggestive of a multifocal osteomyelitis or metastasis. Diagnosis of multifocal tuberculosis is difficult by conventional methods; strong clinical suspicion along with CT guided biopsies and in smear negative cases CBNAAT is strongly emphasized.