Primary Multidrug-Resistant Extrapulmonary Tuberculosis Presenting as Empyema Necessitans in an Immuno-competent Young Girl

Empyema Necessitans (EN) is a variant of empyema that extends to extrapleural space and can affect chest wall too. Although, tuberculosis is the most common cause of EN, primary multidrug resistant TB presenting as EN is rare. Despite the ominous upward trend of drug resistant pulmonary tuberculosis prevalence globally, only sparse reports of extrapulmonary involvement by drug resistant mycobacteria have been documented in literature. Uptill now, culture has been the gold standard for diagnosis of TB. However, the availability of simple and rapid molecular tests has made the diagnosis of extrapulmonary forms of TB possible with high sensitivity and specificity. Here, we report a case of primary Multidrug-Resistant (MDR) extrapulmonary tuberculosis presenting as EN in an immuno-competent young girl