Multifocal tuberculosis

Definition

A rare tuberculosis characterized by two or more extra-pulmonary lesions caused by M. tuberculosis with or without pulmonar involvement, mostly occur in immunocompromised patients. It may affect any site including liver, lymph nodes, lungs, pleura, and the joints. Cutaneous and/or skeletal involvement are rarely reported. Cutenous forms include gummas, scrofuloderma, vasculitis and lupus tuberculosis. Skeletal involvement, that may affect one or more joints, can be dominated by the involvement of large joints that support greater weigh loads, such as the knees and hips and the spine. The symptoms are usually nonspecific, and the disease often presents with an indolent clinical course. Risk factors include human immunodeficiency viruses, immunosuppression due to diverse causes, smoking, malnutrition, diabetes, and stress.