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Unexplained Fever Associated with Musculoskeletal Disorders
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Pain is generally the most common complaint and tuberculosis should always be considered when evaluating the cause of skeletal pain.40 It may be associated with fatigue, anorexia, weight loss, and rarely, local signs and symptoms: limitation of motion, neurologic manifestations, or even rarer a cold abscess.
Tropical infections and infestations
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Any of the cervical group of lymph nodes (jugulodigastric, submandibular, supraclavicular, posterior triangle) can be involved. The patient has the usual general manifestations of tuberculosis: evening pyrexia, cough (maybe from pulmonary tuberculosis) and malaise; if the sufferer is a child, failure to thrive is a significant finding. Locally there will be regional lymphadenopathy where the lymph nodes may be matted; in late stages a cold abscess may form - a painless, fluctuant, mass which is not warm; significantly there are no signs of inflammation (Figure6.35), hence it is called a ‘cold abscess’. This is a clinical manifestation of underlying caseation.
General physical examination
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Lump in anterior triangle (below digastric and in front of sternomastoid muscles):1 Lymph node enlargement (infective; malignant [Hodgkin’s or nonHodgkin’s lymphoma]).2 Abscess (acute abscess; tuberculous ‘cold’ abscess).3 Branchial cyst.4 Cystic hygroma.5 Carotid body tumour (chemodectoma).6 Pharyngeal pouch.
Extrapulmonary tuberculosis
Published in Expert Review of Respiratory Medicine, 2021
Surendra K Sharma, Alladi Mohan, Mikashmi Kohli
The disease process usually begins in the cancellous area of vertebral body in epiphyseal location; sometimes, it may begin in the central or anterior area of vertebral body. The disease spreads and destroys the epiphyseal cortex, intervertebral disc, and adjacent vertebrae. The vertebral body softens and gets compressed and wedging or total collapse of the vertebral body can develop. The exudate penetrates the ligaments and spreads along the path of least resistance to distant sites resulting in cold abscess formation. Almost one-third of the patients with spinal TB develops Pott’s paraplegia. It may occur either early, during the active phase of disease, or later, several years after the disease has become quiescent [2].
Isolated parapharyngeal cold abscess in a 9-year-old boy
Published in Paediatrics and International Child Health, 2019
K. G. Gopakumar, Neha Mohan, V. R. Prasanth, M. K. Ajayakumar
Isolated parapharyngeal cold abscess is very rare unless associated with a retropharyngeal focus. In countries with high incidence of tuberculosis, the possibility of a tuberculous aetiology should always be considered when evaluating a child with a cervical mass.
Costal tubercular osteomyelitis presenting as an orbital abscess
Published in Orbit, 2022
Monalisha Pattnaik, Devjyoti Tripathy
Costal TB is a rare form of skeletal TB and is believed to be second only to malignancy as a cause of rib destruction.5 It is also the commonest cause of an inflammatory lesion of the rib.5 CT imaging features of costal TB osteomyelitis described in the literature are erosion and destruction of the ribs with adjacent abscess formation.4–6 The primary focus of TB is believed to be in the ribs, pleura, or lungs.6 Tuberculous chest wall abscesses are reported to be commonly retromammary in location and have typical imaging features on CT – focal with smooth margins, non-homogeneous, and hypodense with a surrounding enhancing rim.6,7 Ultrasonography shows abscesses as hypoechoic areas with variable internal reflectivity.4 Most of these typical features were present in the current case. However, it differed significantly in some respects from the typical tuberculous “cold abscess” of the chest. There was a complaint of pain with tenderness along with the presence of irregular fever – signs of inflammation not typically seen with a “cold abscess” of the chest. In contrast, the orbital abscess presented without any evidence of active inflammation though the history was quite short. Additionally, orbital CT imaging did not show any evidence of classical periostitis, soft tissue tuberculoma, or bony involvement that are typically described features of orbital TB.8 In the literature, orbital TB has been classified into five different clinical types: (i) classical periostitis, (ii) orbital soft tissue tuberculoma, or cold abscess with no bony destruction, (iii) orbital TB with evidence of bony involvement, not categorized as classical periostitis, (iv) orbital spread from the paranasal sinuses, and (v) dacryoadenitis.8 Primary orbital TB with a typical cold abscess has been reported but, in that case, definite erosive destructive bony changes were evident on imaging.9 In the current case, the history and mode of presentation of the orbital abscess was quite unlike that of a typical cold abscess associated with orbital TB. Formation of a nidus of infection in the orbital cavity could have been a result of hematogenous transmission from the site of the primary chest pathology following secondary infection of the chest wall abscess. Culture of closely related Gram-negative bacilli from both abscess sites appears to be supportive of this hypothesis. However, the exact source of secondary infection of the chest wall abscess and the trigger leading to the hypothesized hematogenous spread of infection from the chest to the orbital cavity was not clearly delineated in the current case.