Soft tissue adipose tissue tuberculosis-rare presentation and difficult to treat

Tuberculosis is a chronic bacterial infection that is caused by mycobacterium tuberculosis. A 22 year old boy presented with complaints of small nodular mass at right hypochondrium which is initially size of 5 rupee coin,on Histopathology s/o (gross)- fibrofatty tissue measuring 7.5x4.5x2.5 cm cut surface. Ill defined friable grayish white to
yellow area, Microscopic-section reveals Langhan’s giant cell and inflammatory infiltrate with extensively caseating epitheliod cells granuloma. Impression- tuberculosis. CBNAAT positive for tuberculosis and shows sensitive for rifampin. after being complete of cat 1. His complaints not resolved completely. Size of nodes decreases but local tenderness and
nodularity remains,. Then he switch to Category 2 under DOTS, after being complete of DOTS category 2 his complaints resolved completely. This case report also helpful in future study of mycobacterium tuberculosis in resides in acidified intracellular compartment in mature adipocytes in dormant stages. And for future design of antimicrobial therapy for rare cases like this.