J Pediatr Infect Dis 2012; 07(01): 027-029
DOI: 10.3233/JPI-2012-0336
Georg Thieme Verlag KG Stuttgart – New York

Polyarticular tuberculosis missed diagnosed as juvenile idiopathic arthritis

Rakesh Mondal
a  Department of Pediatrics, Pediatric Rheumatology Clinic, North Bengal Medical College, Sushrutnagar, Darjeeling, West Bengal, India
,
Pragya Ghosh Pant
a  Department of Pediatrics, Pediatric Rheumatology Clinic, North Bengal Medical College, Sushrutnagar, Darjeeling, West Bengal, India
,
Jayant Kumar Ghosh
a  Department of Pediatrics, Pediatric Rheumatology Clinic, North Bengal Medical College, Sushrutnagar, Darjeeling, West Bengal, India
,
Tapas Sabui
a  Department of Pediatrics, Pediatric Rheumatology Clinic, North Bengal Medical College, Sushrutnagar, Darjeeling, West Bengal, India
› Author Affiliations

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Further Information

Publication History

14 July 2011

24 August 2011

Publication Date:
28 July 2015 (online)

Abstract

We report a child with multiple joint swellings, being treated as a case of poly-articular juvenile idiopathic arthritis subsequently turned out to be tubercular origin. Development of overlying sinuses, lytic lesions on radiographs, synovial fluid analysis showing tubercular infection and demonstration of epitheloid granulomas on bone biopsy confirmed the diagnosis of tubercular poly-arthritis with dactylitis. Child was asymptomatic after two months of starting antitubercular treatment. The case highlights the need to consider the possibility of tuberculosis as aetiology of poly-arthritis, at least in endemic areas, even in the absence of a tuberculosis contact history and overt pulmonary symptoms.