Multifocal tubercular dactylitis in an adult

Musculoskeletal tuberculosis (TB) is a rare manifestation of TB comprising 1%-3% of all cases. We describe a patient who had multiple manifestations of skeletal TB, including spondylitis, dactylitis, and Poncet's disease. The unusual features include multifocal dactylitis, widespread disease in the absence of any risk factor like HIV infection or immunosuppressive treatment, and absence of pulmonary lesion. Treatment with appropriate drugs, using 4 agents for the first 2 months, led to complete recovery. TB can rarely present in an unusual way but is very important to recognize, as with treatment it still carries a good prognosis.