{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:14:00Z","timestamp":1784787240043,"version":"3.55.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Extrapulmonary tuberculosis (TB) accounts for 15%\u201320% of all TB, but soft-tissue involvement of the extremities is distinctly uncommon. Concurrent forearm and bilateral psoas abscesses from drug-resistant\n                    <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                    , in a patient without pulmonary disease, have not \u2013 to our knowledge \u2013 been described. A 16-year-old immunocompetent girl reported right-sided chest pain, a progressively enlarging swelling on the left forearm, anorexia, and weight loss over roughly 2 weeks. Fever, cough, and night sweats were absent, as was any known TB contact. On examination, the forearm lesion was firm and nontender; bilateral lower-abdominal tenderness in the iliac fossae was the only abdominal finding. Cross-sectional imaging identified a solitary forearm abscess together with bilateral psoas collections; magnetic resonance imaging of the lumbosacral spine additionally revealed vertebral-body destruction and paravertebral soft-tissue involvement consistent with Pott\u2019s disease. Chest radiography was unremarkable. GeneXpert MTB\/RIF performed on pus aspirated from both sites confirmed\n                    <jats:italic toggle=\"yes\">M. tuberculosis<\/jats:italic>\n                    complex with rifampicin resistance; a line-probe assay subsequently documented additional resistance to isoniazid and fluoroquinolones \u2013 fulfilling the definition of preextensively drug-resistant (XDR) TB. An all-oral modified longer regimen comprising cycloserine, linezolid, clofazimine, bedaquiline, and delamanid was initiated, with steady clinical recovery. Pre-XDR TB may manifest as disseminated soft-tissue disease at unconventional sites \u2013 forearm and paravertebral musculature \u2013 even when the lungs are radiologically clear. Early molecular resistance testing on pus aspirates shortened the interval to appropriate second-line therapy and likely shaped the favourable trajectory observed here.\n                  <\/jats:p>","DOI":"10.4103\/aam.aam_424_26","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:00:20Z","timestamp":1784786420000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Isolated Forearm Abscess with Bilateral Psoas Abscesses: An Unusual Presentation of Extrapulmonary Preextensively Drug-resistant Tuberculosis without Pulmonary Involvement"],"prefix":"10.4103","author":[{"given":"Sanjay","family":"Gabhale","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balamoni Vinay Kumar","family":"Goud","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai Karthik","family":"Guniganti","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,22]]},"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/aam.aam_424_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:00:20Z","timestamp":1784786420000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/aam.aam_424_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/aam.aam_424_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"2026-04-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}