Mycobacterium tuberculosis osteomyelitis in a patient with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS): a case report

Abstract

The incidence of tuberculosis is increasing in the United States. Extra-pulmonary involvement is more common in patients with HIV/AIDS. The diagnosis of Tuberculosis osteomyelitis requires a high degree of suspicion for accurate and timely diagnosis.We present a case of a 49 year old Caucasian male with HIV/AIDS who presented with a four-month history of soft tissue swelling in the left proximal thigh unresponsive to various broad spectrum antibiotics who was eventually diagnosed with Mycobacterium tuberculosis osteomyelitis of the left proximal femur.

Figure 1

CT scan of left lower extremity showing a 25 mm × 40 mm × 140 mm fluid collection (↔) and peripheral enhancement of the gluteus medius and vastus lateralis muscles.

Figure 2

MRI of the left thigh showing loculated fluid collection (↔) contiguous with the gluteus medius and pyriformis muscles.

Figure 3

MRI of the left thigh showing a sinus tract (↔) from the proximal femur.