{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:07Z","timestamp":1756425787348,"version":"3.44.0"},"reference-count":27,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,8,10]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>This case involves a man with longstanding Crohn\u2019s disease on azathioprine therapy who developed a rare manifestation of tuberculosis, presenting as a subcutaneous tuberculous abscess and tuberculous spondylitis. The patient\u2019s immunocompromised state due to azathioprine raised the risk for opportunistic infections. The unique aspects include the absence of disseminated tuberculosis and the development of tuberculous paraspinal and subcutaneous abscesses in a patient with Crohn\u2019s disease. The case underscores the importance of vigilance for rare infections in immunosuppressed individuals and highlights the need for tuberculosis screening before initiating immunosuppressive therapies. The patient was successfully treated with antituberculous medication, emphasising the importance of a tailored approach in managing such cases.<\/jats:p>","DOI":"10.1136\/bcr-2024-260389","type":"journal-article","created":{"date-parts":[[2024,8,24]],"date-time":"2024-08-24T04:47:41Z","timestamp":1724474861000},"page":"e260389","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Subcutaneous and paraspinal tuberculous abscesses in a patient with Crohn\u2019s disease"],"prefix":"10.1136","volume":"17","author":[{"given":"Zohair","family":"Karim","sequence":"first","affiliation":[{"name":"Medicine, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahab","family":"Abid","sequence":"additional","affiliation":[{"name":"Gasteroenterology, Aga Khan University Hospital, Karachi, Sindh, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,24]]},"reference":[{"key":"2025082801201083000_17.8.e260389.1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-020-00360-x"},{"key":"2025082801201083000_17.8.e260389.2","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1111\/apt.15160","article-title":"Trends in the epidemiology of inflammatory bowel disease among Jewish Israeli adolescents: a population-based study","volume":"49","author":"Ghersin","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"2025082801201083000_17.8.e260389.3","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v18.i15.1723"},{"key":"2025082801201083000_17.8.e260389.4","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1136\/gut.2006.114660","article-title":"Opportunistic infections in patients with inflammatory bowel disease: prevention and diagnosis","volume":"57","author":"Viget","year":"2007","journal-title":"Gut"},{"key":"2025082801201083000_17.8.e260389.5","doi-asserted-by":"crossref","first-page":"6993","DOI":"10.3748\/wjg.v26.i44.6993","article-title":"Active tuberculosis in inflammatory bowel disease patients under treatment from an endemic area in Latin America","volume":"26","author":"Fortes","year":"2020","journal-title":"World J Gastroenterol"},{"key":"2025082801201083000_17.8.e260389.6","doi-asserted-by":"crossref","first-page":"16303","DOI":"10.1038\/srep16303","article-title":"The increased risk of active tuberculosis disease in patients with dermatomyositis - a nationwide retrospective cohort study","volume":"5","author":"Wu","year":"2015","journal-title":"Sci Rep"},{"key":"2025082801201083000_17.8.e260389.7","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jaci.2022.09.010","article-title":"Azathioprine therapy induces selective NK cell depletion and IFN-\u03b3 deficiency predisposing to herpesvirus reactivation","volume":"151","author":"Ingelfinger","year":"2023","journal-title":"J Allergy Clin Immunol"},{"key":"2025082801201083000_17.8.e260389.8","doi-asserted-by":"crossref","first-page":"96S","DOI":"10.1177\/2192568218769053","article-title":"Spinal Tuberculosis: current Concepts","volume":"8","author":"Rajasekaran","year":"2018","journal-title":"Glob Spine J"},{"key":"2025082801201083000_17.8.e260389.9","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3390\/clinpract13010014","article-title":"Pathogenesis, Diagnostic Challenges, and Risk Factors of Pott\u2019s Disease","volume":"13","author":"Glassman","year":"2023","journal-title":"Clin Pract"},{"key":"2025082801201083000_17.8.e260389.10","doi-asserted-by":"crossref","first-page":"78","DOI":"10.5152\/eurjrheumatol.2014.014","article-title":"A rare location of sacral tuberculosis: a report of three cases","volume":"1","author":"Lazrak","year":"2014","journal-title":"Eur J Rheumatol"},{"key":"2025082801201083000_17.8.e260389.11","first-page":"209","article-title":"Sacrum Pott\u2019s disease: a rare location of spine tuberculosis","volume":"36","author":"Oniankitan","year":"2014","journal-title":"The Egyp Rheum"},{"key":"2025082801201083000_17.8.e260389.12","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2021.802298","article-title":"Development of Spinal Tuberculosis in an Adolescent With Crohn\u2019s Disease After Infliximab Therapy: a Case Report With Literature Review","volume":"9","author":"Jung","year":"2021","journal-title":"Front Pediatr"},{"key":"2025082801201083000_17.8.e260389.13","first-page":"1296","article-title":"Paraspinal tuberculosis mimicking malignancy","volume":"34","author":"Alherabi","year":"2013","journal-title":"Saudi Med J"},{"key":"2025082801201083000_17.8.e260389.14","doi-asserted-by":"crossref","DOI":"10.1051\/sicotj\/2018005","article-title":"Tuberculous lumbar spinal epidural abscess in a young adult (case report)","volume":"4","author":"Hasan","year":"2018","journal-title":"SICOT J"},{"key":"2025082801201083000_17.8.e260389.15","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.1093\/ibd\/izz056","article-title":"Prevalence of Fistulizing Crohn\u2019s Disease in the United States: estimate From a Systematic Literature Review Attempt and Population-Based Database Analysis","volume":"25","author":"Schwartz","year":"2019","journal-title":"Inflamm Bowel Dis"},{"key":"2025082801201083000_17.8.e260389.16","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jcol.2016.05.003","article-title":"Current management of spontaneous intra-abdominal abscess in Crohn\u2019s disease","volume":"38","author":"Carvalho","year":"2018","journal-title":"J Coloproctol"},{"key":"2025082801201083000_17.8.e260389.17","first-page":"103624","article-title":"Paraspinal and Extensive Epidural Abscess: the Great Masqueraders of Abdominal Pain","volume":"2015","author":"Chu","year":"2015","journal-title":"Case Rep Neurol Med"},{"key":"2025082801201083000_17.8.e260389.18","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1590\/S1806-37132015000004388","article-title":"Cutaneous tuberculosis as metastatic tuberculous abscess","volume":"41","author":"Pacheco","year":"2015","journal-title":"J Bras Pneumol"},{"key":"2025082801201083000_17.8.e260389.19","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1766-8"},{"key":"2025082801201083000_17.8.e260389.20","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2014.941919"},{"key":"2025082801201083000_17.8.e260389.21","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.3748\/wjg.v29.i9.1536","article-title":"Thiopurines are an independent risk factor for active tuberculosis in inflammatory bowel disease patients","volume":"29","author":"Fortes","year":"2023","journal-title":"World J Gastroenterol"},{"key":"2025082801201083000_17.8.e260389.22","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s12890-021-01444-3","article-title":"An unusual case of reactivated latent pulmonary cryptococcal infection in a patient after short-term steroid and azathioprine therapy: a case report","volume":"21","author":"Pan","year":"2021","journal-title":"BMC Pulm Med"},{"key":"2025082801201083000_17.8.e260389.23","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.04.012"},{"key":"2025082801201083000_17.8.e260389.24","doi-asserted-by":"publisher","DOI":"10.1080\/003655201750305567"},{"key":"2025082801201083000_17.8.e260389.25","doi-asserted-by":"publisher","DOI":"10.1136\/gut.34.8.1081"},{"key":"2025082801201083000_17.8.e260389.26","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B7.24668"},{"key":"2025082801201083000_17.8.e260389.27","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2012.6.4.294"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-260389","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:20:21Z","timestamp":1756369221000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-260389"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8]]},"references-count":27,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,24]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/bcr-2024-260389"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-260389","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,8]]}}}