# Spina Ventosa of the Left Ring Finger With Tuberculous Pyomyositis in the Forearm Muscles in a Young Immunocompetent Indian Male With No Pulmonary Involvement: A First Report of Its Type

## TL;DR

A 15-year-old Indian male developed a rare case of spina ventosa and forearm muscle tuberculosis without lung involvement, diagnosed through detailed testing and successfully treated.

## Contribution

This is the first reported case of spina ventosa and forearm tuberculous pyomyositis occurring together in an immunocompetent individual without pulmonary involvement.

## Key findings

- Spina ventosa and forearm pyomyositis caused by Mycobacterium tuberculosis were diagnosed in a non-immunocompromised patient.
- The case highlights the importance of detailed diagnostic workup for rare extrapulmonary tuberculosis presentations.
- Antituberculous treatment led to significant clinical improvement.

## Abstract

Tuberculous infection of the extrapulmonary sites, especially the small bones, is a seldom reported entity even in endemic countries. Moreover, simultaneous involvement of the forearm muscles is a very rare presentation with no such case reported showing concurrent involvement of the two sites. The diagnosis is challenging due to the paucibacillary nature of the disease, a lack of awareness among primary clinicians, and ambiguity in clinical features with other musculoskeletal disorders, especially when there is no pulmonary involvement. Herein, we present a first-of-its-type case of spina ventosa of the left ring finger with a tuberculous abscess in the forearm in a 15-year-old Indian male with no pulmonary seeding. The diagnosis was achieved through a detailed diagnostic workup, which resulted in the detection of Mycobacterium tuberculosis. He was initiated on antituberculous treatment with a remarkable improvement.