Primary Rifampicin Drug Resistant Disseminated Extrapulmonary Tuberculosis

Disseminated tuberculosis (TB) refers to involvement of two or more non-contiguous sites. It is a common mode of presentation of tuberculosis in patients both with and without HIV/AIDS in India. However, the presence of primary drug resistance in disseminated tuberculosis involving only the extrapulmonary sites in an immunocompetent adult is rare. Extrapulmonary TB accounts for approximately 15% of the TB cases among immunocompetent hosts and for 50%–70% of cases of TB occurring in immunocompromised individuals, especially in persons with HIV. Rifampicinresistant tuberculosis is caused by bacteria that do not respond to Rifampicin, one of the most powerful anti-TB medicines. These patients require MDR-TB treatment. Here we present a case of a 32 year old male painter with primary Rifampicin resistant disseminated tuberculosis in the form of cold abcess, tuberculous spondylitis, epidydmitis and scrofuloderma.