A case of tuberculous tenosynocitis

Eom, Sang Cheol; Kim, Kwang; Suc, Kee Suck; Kim, Sang Tae

Abstract

The sheaths of tendons are an uncommon site of tuberculous invclvement as compared to other parts of the body. But tuberculou, tenosynovitis occurs often enough to varrant particular attention and study. We report a case of tuberculous tenosynovitis occuring in a 49-year-old woman who had multiple yellowish palpable nodules and swellings distributed along the tencon of flexor digitorum superficialis on the left palm for 3 month. Histopathologic findings showed multip e tuberculoid granulomas in the mid-and deep-dermis. Eosinophilic homogenous trabeculated structure(remnants of tendon sheath resistant to necrosis) was present within the area of caseation. Acid-fast stain showed a crowd of acid-fast bacilli in the deep dermis. The cultures from the skin biopsy spec mens on Ogawa media(3% KH PO4) at 24C, 32C and 37C were all negative. She was treated with surgical excision of granulation tissue and involved tendon sheath followed by systemic administration of INH, RIF and ethambutol for 1 year. The lesions were markedly improved and showed no relaps, during last 5 months of follow up period.