Atypical presentation of tuberculosis.

Incidence of tuberculosis is increasing with emergence of many cases of multi-drug resistance and extrapulmonary manifestation. We report three cases of tuberculosis presenting in very atypical ways. An eight-year old child was brought with complaints of progressive increasing neck pain and restricted neck movements from past fifteen days. There was no history of any constitutional symptoms and exposure to tuberculosis. On examination all neck movements were grossly restricted and were painful. He had mild trismus as well. Intraoral examination revealed bulge on the right lateral pharyngeal wall just behind the tonsillar fossa. Systemic examination was normal. Investigations revealed lymphocytosis ESR of 55 mm positive Mantoux test. X-ray cervical spine and chest were normal. (excerpt)