Subcutaneous and paraspinal tuberculous abscesses in a patient with Crohn's disease

BMJ Case Rep. 2024 Aug 24;17(8):e260389. doi: 10.1136/bcr-2024-260389.

Abstract

This case involves a man with longstanding Crohn's disease on azathioprine therapy who developed a rare manifestation of tuberculosis, presenting as a subcutaneous tuberculous abscess and tuberculous spondylitis. The patient's immunocompromised state due to azathioprine raised the risk for opportunistic infections. The unique aspects include the absence of disseminated tuberculosis and the development of tuberculous paraspinal and subcutaneous abscesses in a patient with Crohn's disease. The case underscores the importance of vigilance for rare infections in immunosuppressed individuals and highlights the need for tuberculosis screening before initiating immunosuppressive therapies. The patient was successfully treated with antituberculous medication, emphasising the importance of a tailored approach in managing such cases.

Keywords: Crohn's disease; Infections; Inflammatory bowel disease; TB and other respiratory infections; Unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Abscess* / drug therapy
  • Abscess* / microbiology
  • Adult
  • Antitubercular Agents* / therapeutic use
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use
  • Crohn Disease* / complications
  • Crohn Disease* / drug therapy
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Tuberculosis, Spinal* / complications
  • Tuberculosis, Spinal* / diagnosis
  • Tuberculosis, Spinal* / drug therapy

Substances

  • Antitubercular Agents
  • Immunosuppressive Agents
  • Azathioprine