# Tuberculosis of the Femur With Intramedullary Abscesses and No Pulmonary Foci in an Immunocompetent Male: A Rare Case

## TL;DR

A rare case of femur tuberculosis in an immunocompetent man was diagnosed using MRI and a nucleic acid test, with no lung involvement.

## Contribution

Highlights a rare extrapulmonary tuberculosis case in an immunocompetent individual without pulmonary foci.

## Key findings

- MRI and nucleic acid amplification test confirmed femur tuberculosis in an immunocompetent male.
- No pulmonary foci or tuberculosis contact history were present in the patient.

## Abstract

Tuberculosis of the long bones/femur, especially in an immunocompetent person, is a challenging diagnosis. It is a rare entity, even in endemic settings. The non-specific clinical features, backed by a low suspicion about such presentations even in endemic settings, may result in delayed diagnosis and often unfavorable treatment outcomes. The situation becomes even more challenging in the absence of pulmonary foci and a contact history of tuberculosis. Here is a case of a young adult male who presented with complaints of pain over his left leg for three months. A diagnosis was achieved with magnetic resonance imaging and the isolation of the bacteria from a bone biopsy using a cartridge-based nucleic acid amplification test. Antituberculous treatment was promptly initiated.