Disseminated extrapulmonary tuberculosis revealed by humeral osteomyelitis with chronic unremarkable pain

Disseminated extrapulmonary tuberculosis is uncommon, particularly among immunocompentent individuals. We report the case of a 38-year-old woman from the Ivory Coast who had osteomyelitis in the right humerus, a cold abscess in the pectoralis major muscle, T11 spondylitis, deep lymphadenopathies, peritoneal nodules, and hepatitis. She had no evidence of immune deficiency, and her only risk factor for tuberculosis was her origin from an endemic area. The outcome was favorable after treatment with antitubercular drugs. This case illustrates the recent changes in the epidemiology of tuberculosis in France, where the incidence among immigrants is rising. It also serves as a reminder that tuberculosis can run a chronic and extremely insidious course. At diagnosis, our patient had a 2-year history of chronic pain in her right shoulder and back, suggestive of a minor mechanical disorder.