# Disseminated tuberculosis with rare coccygeal involvement: a case report

## TL;DR

This case report describes a rare instance of tuberculosis affecting the coccygeal region in a 64-year-old diabetic patient, successfully diagnosed and treated with non-invasive methods.

## Contribution

The novelty lies in the rare coccygeal TB localization in an immunocompetent individual, diagnosed non-invasively.

## Key findings

- TB was diagnosed using Xpert MTB/RIF, confirming Mycobacterium tuberculosis infection.
- The patient showed complete symptom resolution after starting anti-TB therapy.
- The case emphasizes the importance of considering rare TB locations in diagnostic evaluations.

## Abstract

Tuberculosis (TB) is a preventable and usually curable disease but remains a major health problem worldwide, particularly in developing countries. TB of the lumbosacral junction is rare and occurs in only 1–2% of all cases of spinal TB. Moreover, isolated sacrococcygeal TB is extremely rare. We present a case of a 64-year-old patient with a history of diabetes who presented with chronic back pain and cough. Physical examinations revealed a perianal fistula and left elbow joint arthritis. The patient is diagnosed with disseminated TB with coccygeal involvement. Diagnosis was achieved non-invasively using Xpert MTB/RIF, confirming Mycobacterium tuberculosis infection. The patient experienced complete resolution of symptoms following the commencement of anti-TB therapy. We highlight the importance of this case due to the rare coccygeal localization of TB in an immunocompetent patient, diagnosed through non-invasive means.