Tuberculosis of the Humerus

We present a case of 39-year-old man in whom pathologic changes in the left humerus were diagnosed after one year of corticosteroid therapy due to suspicion of lung sarcoidosis. Bone biopsy was carried out with subsequent development of cutaneous fistula with exuding purulent content. Tuberculosis was diagnosed based on histopathological and bacteriological tests. The patient received typical antituberculous therapy for 6 months, which resulted in healing of the fistula. Six months later an abscess developed within the muscles of the left arm. Magnetic resonance revealed lesions suggestive of tuberculosis of the left humerus with the presence of two fistulas and an intramuscular abscess. The patient received another course of antituberculous treatment and the content of the fistula was removed. After 8 months of therapy, the fistula was healed, although the lesions in the humerus regressed only partially so the therapy was prolonged to 12 months.