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KMID : 0882420140860060785
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Korean Journal of Medicine
2014 Volume.86 No. 6 p.785 ~ p.790
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A Case of Musculoskeletal Tuberculosis Mimicking Adult-Onset Still’s Disease
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Cho Jin-Kyeong
Kim Min-Sung
Shin Jin-Ho
Jeong Yeon-Sang
Kim Joon-Wan
Choi Jae-Phil
Choi Byoong-Yong
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Abstract
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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.
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KEYWORD
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Fever of unknown origin, Mycobacterium tuberculosis, Osteoarticular, Still’s disease, Adult-onset
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