Case history
Case history #1
A 42-year-old woman presents to her primary care physician with a 7-week history of an enlarging mass on the left side of her neck. She denies pain or drainage. The mass failed to respond to antibiotics. She denies cough, fever, night sweats, or anorexia. She is originally from Vietnam but has lived in the US for 4 years. She denies any history of TB or TB exposure. Physical examination reveals a well-appearing woman. There is a 2 x 4 cm left neck mass consistent with a lymph node in the anterior cervical chain. There is no tenderness; the node is firm and mobile. There are smaller subcentimetre lymph nodes in the left supraclavicular fossa. The physical examination is otherwise unremarkable.
Case history #2
A 66-year-old man presents to the emergency department with a history of fever and weight loss. He reports that he has had little appetite for the last 3 months and has lost 11 kg during that time. He has noted tactile fevers over the last 6 weeks but has not had access to a thermometer. He has been having headaches for the last week but denies cough, haemoptysis, or chest pain. He has been intermittently homeless over the last 2 years and has a history of heavy alcohol use but recently stopped. On examination, he is a thin man with a temperature of 38.8°C (101.9°F) and a respiratory rate of 20 breaths per minute. Physical examination is notable for temporal wasting and hepatomegaly without tenderness.
Other presentations
The spectrum of EPTB is extremely broad and signs and symptoms include those related to the involved organ system and non-specific constitutional symptoms.
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