To the Editor:
Tuberculosis remains a worldwide major global health problem. Osteoarticular tuberculosis represents 1%–2% of cases. Multifocal skeletal forms are exceptional even in endemic countries and affect mainly immunocompromised patients. It is usually associated with a primary pulmonary tuberculosis1,2. Clinical presentation is often misleading and contributes to a delay in diagnosis. We describe 2 cases of multifocal skeletal tuberculosis in young immunocompetent patients, both coming from Africa and living in France for 3 years.
Case 1
A 12-year-old girl, a native of Ghana, presented with a 3-month history of lumbar pain and rapid-onset S1 left radicular distribution. She had a history of asthenia with weight loss of 3 kg without fever. On examination, she had tenderness over the thoracolumbar spine, with muscle spasm and stiffness. Lasegue’s sign was positive without any neurologic deficiency. Imaging [plain radiographs, computed tomography (CT), magnetic resonance imaging (MRI)] revealed lytic lesions of the ninth and tenth ribs, wedging of the body of T12 with soft-tissue edema, and bone destruction of …
Address correspondence to Dr. Gomez-Brouchet; E-mail: Brouchet.anne{at}chu-toulouse.fr