Tuberculous Adrenal Abscess Presenting as Adrenal Insufficiency in a 4-Year-Old Boy.

We describe the case of a 4.8-year-old boy who presented with adrenal crisis. The advent of symptoms of adrenal insufficiency in the patient was at around 2 years of age. Congenital causes of adrenal insufficiency were considered over acquired etiologies owing to early onset of symptoms. However, on evaluation, he was found to have left adrenal abscess of tuberculous etiology. The aspirate culture grew multidrug-resistant Mycobacterium tuberculosis complex. He was initiated on glucocorticoid and mineralocorticoid replacement, along with second-line antitubercular therapy. Unique features of our case were early presentation, primary adrenal TB causing adrenal insufficiency, unilateral involvement with adrenal abscess localization, no identifiable extra-adrenal site of tubercular dissemination and resistance to first-line TB drugs.

Poncet's disease in an adolescent with abdominal tuberculosis.

Poncet disease is a rare, acute-onset polyarthritis associated with active extra-articular tuberculosis (TB) without evidence of active infection in the affected joint and resolves without residual joint damage or long-term complications. Most cases are reported at the commencement of anti-tuberculous therapy (ATT). A 13-year-old girl with Poncet disease is reported which, despite almost 6 months of treatment for abdominal TB, manifested with bilateral knee joint involvement which resolved only with continuation of ATT. A synovial biopsy was sterile.