Bilateral Tuberculous Dactylitis of both hand and feet in a female toddler: A Case Report on a Rare Presentation of Skeletal Tuberculosis in children

Abstract Background Even though Tuberculosis is a common disease among children in developing countries, tuberculous dactylitis is an uncommon form of Skeletal tuberculosis specially with involvement of both the hands and feet. Case Presentation A 1 year and 6 months old previously healthy female ethiopian toddler presented to our pediatric outpatient clinic with a 2 month duration of painful multiple swellings over both her hands and feet. The swelling involved the proximal phalanx of left index finger, dorsum of the right hand and dorsum of both feet over the 1st metatarsal bone. Physical examination, radiologic findings Histopathology suggested tuberculous dactylitis. The patient was treated with Anti tuberculosis drugs for 12 months and clinical radiologic examination showed marked improvement and recovery. Conclusion Tubercular dactylitis should always be considered in the differential diagnosis of children from endemic areas presenting with bone and joint pain or swelling. Our experience of 12 months course of Anti TB which is in line with WHO recommendations of treatment of skeletal Tuberculosis, showed excellent outcome.