An unusual presentation of extrapulmonary tuberculosis in an adolescent: Isolated unilateral inguinal lymphadenitis

Isolated tuberculous inguinal lymphadenitis is a rare entity and is usually bilateral. A 16-year-old male presented with anorexia, nocturnal sweating and painless soft right inguinal lymph nodes. The patient underwent excision of lymph nodes and a Ziehl-Neelsen stain revealed the presence of acid-fast bacilli, but cultures of the lymph nodes were negative. Histological sections showed the presence of caseous necrosis and epithelioid cell granuloma. He had a positive tuberculin skin test (Mantoux) with 22 mm diameter. The patient was diagnosed as tuberculous lymphadenitis with these findings. Tuberculosis should be included in the differential diagnosis in any case of isolated chronic unilateral inguinal lymphadenitis, especially in developing countries.