Breast Tuberculosis in a 21-Year-old Female Patient: A Case Report
Vinutha S R *
Bangalore Medical College, India.
Ravi S
Bangalore Medical College, India.
Manjunath B D
Bangalore Medical College, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Primary mammary tuberculosis is a rare form of extrapulmonary TB, typically spreading to the breast from nearby lymph nodes, ribs, or pleura. It's uncommonly the initial infection site and is predominantly found in multiparous women during their reproductive or lactating years. Breast tuberculosis should be considered as one of the differential diagnosis of Granulomatous Mastitis
Case Presentation: A 21-year-old woman presented with left breast pain and a 3x3 cm palpable lump, alongside unexplained weight loss. Examination showed a firm, mobile mass in the upper outer quadrant of an enlarged left breast, with no associated skin changes or swollen lymph nodes with no other significant positive history.
Discussion: Breast ultrasound revealed a lesion with inflammatory changes, but initial aspiration yielded no bacterial growth. Subsequent analysis of persistent discharge confirmed Mycobacterium tuberculosis through ZN stain and CBNAAT, leading to ATT initiation. The patient later developed abdominal and rifampicin-resistant cerebral tuberculosis, necessitating an MDR regimen. There are limited cases of ziehl -neelsen stain proved cases of breast tuberculosis.
Conclusion: Breast tuberculosis is treated with a six-month anti-tubercular chemotherapy regimen, with surgery reserved for specific indications like diagnosis or abscess drainage. Suspicion should be made in unresponsive breast abscess or presenting with a fistulae or nodules.
Keywords: Breast ultrasound, mammary tuberculosis, dyspnea, Mycobacterium tuberculosis