Pulmonary Tuberculosis with Acute Gout Arthritis in East Nusa Tenggara: A Case Report

Tuberculosis (TB) is one of the oldest infectious disease known to affect human and caused by bacteria from Mycobacterium group that has the highest mortality rate in the world. The main bacteria ismycobacterium tuberculosis that most ofteninfect lungs. Although pulmonary TB is curable if treated properly, there could be adverse effect from the anti-TB drugs. Hyperuricemia is a common adverse effect from pyrazinamide, while clinical gout requiring a treatment is rare.A 69-years-old man with Pulmonary TB complaint about pain in all of his joints for the last 7 days while taking anti-TB drugs for about 2 month.Physical examination reveal multiple masses with tenderness at right toe, left ankle, knee bilateral and left thumb. Uric acid 4.71mg/dL.Diagnosed as pulmonary TB and acute gout arthritis then treated with analgesic IV and colchicine while still giving Anti-TB drugs. Knowledge of these adverse effects is important especially for clinician in endemic countries. Miss-diagnosed lead to wrong medication that could exacerbationacute gout. While not life-threatening, screening for hyperuricemia could prevent complication from anti-TB drugs.