Abstract / Summary
Abstract Background Cutaneous tuberculosis is a rare manifestation of extrapulmonary tuberculosis in children. Scrofuloderma is the most common manifestation of cutaneous tuberculosis in developing countries. It results from the direct extension of tuberculosis infection from an underlying infected structure, such as lymph nodes, bones, or joints, to the overlying skin. We report a remarkable case of scrofuloderma extending to the chest wall in an adolescent male. Case presentation A 16-year-old Indonesian male who had received six months of inadequate-dose tuberculosis treatment presented to our Pediatric Respirology Clinic with a complaint of a new cervical nodule. He had a prior history of bilateral cervical nodules and a mass on the right chest wall. The patient had previously received inadequate dose of antituberculosis therapy. Fine-needle aspiration biopsy of the cervical nodules confirmed tuberculous lymphadenitis. A thoracic CT scan revealed an abscess, and thoracotomy with aspiration was performed. Histopathological examination confirmed tuberculous inflammation of the chest wall. He was restarted on adult fixed-dose combination antituberculosis therapy at an adequate dose for 12 months. As a result, the nodules resolved, skin lesions healed, and significant weight gain occurred. Conclusion In high TB-burden settings, clinicians should recognize the varied manifestations of tuberculosis. Early diagnosis using histopathology and molecular testing, along with a combination of surgical intervention and appropriate anti-tuberculosis therapy, is essential to achieve favorable outcomes. In adolescents, multidisciplinary management and close monitoring are key to achieving favorable outcomes and preventing recurrence.