RESUMO
A 25-year-old female patient from India suffered from diffuse pain in the upper and lower abdomen, caused by infiltrative changes of the ovaries and intraabdominal fluid. The patient refused further examinations. 11 months later she endured additional pain of the thorax and the left shoulder. An opacity in the left lung and costal destruction was diagnosed. Puncture of the lung process showed a granulomatous inflammation including Langerhans cells. The puncture of a peritoneal thickening also showed inflammation. Microscopic examination was negative for mycobacteria, but PCR and the culture for Mycobacterium tuberculosis after 8 weeks were positive, with full sensibility, so treatment with RMP, INH, PZA and EMB was initiated. The lung process improved but the abdominal complaints were progressive due to a pyosyalpinx requiring surgical removal. The further course was uneventful. Two years after diagnosis the patient is in a good condition now.
