Multifocal tuberculosis.

A 19 -year-old salesman presented with multiple fusiform, fluctuant, nontender swellings involving dorsum of left hand, left index finger and little finger. He also had multiple sinuses with puckered scars on right thumb, left little finger, and right elbow. He was provisionally diagnosed as tuberculous gumma and was investigated further. X-ray chest showed apical cavity and infiltration suggestive of tuberculosis. X-ray both hands showed osteolytic lesion with pathological fracture. AFB was cultured on Lowenstien Jensen s medium and the patient was put on ATT with clinical improvement.