Introduction Tuberculosis mastitis is a rare manifestation of tuberculosis. Clinical manifestations can be variable and unusual. Routine laboratory and imaging tests may yield nonspecific results making diagnosis challenging.
Clinical details A 33-year-old, healthy, nonlactating, female presented with a 15-day history of high fever, pain, and swelling of the left (Lt) breast. Examination revealed tender breast swelling with erythema of overlying skin. No breast lump/axillary lymphadenopathy was palpable. Nipple and areola were normal. No sinus/ulcer present. X-ray chest was normal. No tuberculous focus is present.
Differential diagnosis includes breast abscess, mastitis, fungal infections, and granulomatous diseases. Mammography and ultrasound are not diagnostic of breast tuberculosis. Fine needle aspiration cytology (FNAC) is useful only in presence of a breast lump. Open biopsy/surgical debridement may be required for confirmation.
Conclusion A high index of clinical suspicion with appropriate diagnostic tests and a standard antitubercular drug regimen is needed for a complete cure.