Rare Case of Pulmonary Tuberculosis Presenting as Subcutaneous Swelling and Nodular Pleural Thickening: A Case Report

Tuberculosis (TB) is a global health concern and can affect various organs, including the pleura1 . Pleural involvement in TB often presents as pleural effusion and smooth pleural thickening 2. We present a case of a 12-year-old male who presented with complaints of fever, weight loss and painful subcutaneous swelling below the lower left 9th rib. Ultrasound screening was done to evaluate the painful soft tissue lesion in the lower left antero-lateral chest wall, findings revealed a collection with necrotic areas within on the left side along with minimal right sided pleural effusion. HRCT Chest Imaging revealed nodular right pleural thickening with minimal right pleural effusion along with other findings as seen on the left side on USG. The patient was diagnosed with tuberculous pleural thickening based on cartridge based nucleic acid amplification test (CBNAAT) examination of the fine needle aspiration cytology (FNAC) guided pleural fluid aspiration and analysis. The case highlights the importance of considering TB as a potential etiology for nodular pleural thickening, even in a young patient, particularly in high TB burden regions.