Background: Tuberculous osteomyelitis is a rare form of extrapulmonary tuberculosis. In the diagnosis and management of this disease, the combined evaluation of radiological, histopathological, and microbiological findings is important for establishing a definitive diagnosis and guiding treatment.
Case Report: We present a case of infection caused by Mycobacterium tuberculosis complex in a 65-year-old patient who presented with pain, swelling, and tenderness in the left tibia and showed no improvement despite long-term antibiotic treatment. Ziehl–Neelsen (EZN) staining of the pus specimen was negative. Culture results using Löwenstein–Jensen medium and the Mycobacteria Growth Indicator Tube (MGIT) 960 system were positive. Polymerase chain reaction (PCR) testing was negative in the pus specimen but positive in the biopsy specimen. Drug susceptibility testing showed that the isolated Mycobacterium tuberculosis strain was susceptible to isoniazid and rifampin.
Conclusion: In cases of osteomyelitis that do not improve with long-term treatment, infection caused by Mycobacterium tuberculosis complex should be considered.