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Korean J Med > Volume 86(6); 2014 > Article
The Korean Journal of Medicine 2014;86(6): 785-790.
성인형 스틸병과 유사한 임상양상을 보인 다발성 골 결핵 1예
조진경, 김민성, 신진호, 정연상, 김준완, 최재필, 최병용
서울특별시 서울의료원 내과
A Case of Musculoskeletal Tuberculosis Mimicking Adult-Onset Still’s Disease
Jin Kyeong Cho, Min Sung Kim, Jin Ho Shin, Yeon Sang Jeong, Joon Wan Kim, Jae Phil Choi, Byoong Yong Choi
Department of Internal Medicine, Seoul Medical Center, Seoul, Korea
Corresponding Author: Byoong Yong Choi ,Tel: +82-2-2276-7812, Fax: +82-2-2276-7820, Email: atom9752@hanmail.net
Received: August 13, 2013;   Revised: September 25, 2013;   Accepted: October 16, 2013.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
A 46-year-old man was admitted to our hospital because of a fever of unknown origin. The patient had a skin rash, arthralgia, and hepatosplenomegaly. Laboratory tests showed leukemoid leukocytosis, a high serum ferritin level (31,200 ng/mL), and abnormal liver function tests. He was initially diagnosed with adult-onset Still’s disease (AOSD). However, imaging studies incidentally detected a cold abscess involving the 11th thoracic vertebra. A biopsy of the abscess revealed histologically granulomatous caseous necrosis, positive for M. tuberculosis by polymerase chain reaction. We present a patient with musculoskeletal tuberculosis (TB) that clinically mimicked AOSD. In TB-endemic countries, extrapulmonary TB should be included in the differential diagnosis of AOSD. (Korean J Med 2014;86:785-790)
Keywords: Fever of unknown origin; Mycobacterium tuberculosis; Osteoarticular; Still’s disease; Adult-onset
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