A case of tuberculosis forming cervical and abdominal abscesses

The patient was a 31-year-old man with a chief complaint of cervical mass close to the right submandibular region. At first, we used several antibiotics, which proved to be ineffective. Radiological and laboratory investigations were performed, including chest X-ray and computed tomography of the neck. Purified protein derivative test (PPD test) was positive. Definitive diagnosis of mycobacterial cervical lymphadenitis was made according to the findings of pathological examination and positive mycobacterial culture of the biopsy material. Since the patient had irritation in the stomach at the same time, we examined his abdomen by gastrofiberscope and MRI. As a result, abdominal abscesses were detected with high activity of adenosinedeaminase in the fluid inside. These results suggested that they also were tuberculous abscesses. Four months were required for this patient to recover from mycobacterial cervical lymphadenitis after combined antituberculous pharmacotherapy. After one year, we have also seen improvement in his abdominal abscesses.