Suspected reactivation of extrapulmonary tuberculosis focus after non-medical abuse of anabolic androgenic steroids: a case report
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Vikramjit Singh
Abstract
Background
Youth population has a common tendency to use androgenic steroids. The reasons for such abuse vary from performance enhancement to muscle building in order to enhance physical appearance. Such rampant abuse, aided by fitness centers and gym trainers, has a huge risk of side effects such as hepatic dysfunctions and increased risk of infections.
Case presentation
We report a case of 21-year-old man who started with anabolic steroids, namely testosterone enanthate, nandrolone decanoate and boldenone undecylenate injections, for the purpose of muscle building and strength training at his fitness center. He presented to his family physician after 2 months with upper neck swelling on right side 5 × 4 cm for 15–20 days. He was started on Augmentin 625 mg tablet three times a day for 7 days. On seventh day, swelling persisted, and fine needle aspiration cytology (FNAC) was performed, which was suggestive of granulomatous lesion likely to be tuberculosis. The patient was started with anti-tubercular therapy (ATT) under category A, but swelling did not improve and repeated FNAC was advised. The ATT was withheld and Augmentin tablet was restarted for another 3 days. A revised diagnosis of acute suppurative lymphadenitis was made, and an incision and drainage of the abscess was performed. The patient was started on Amikacin 500 intramuscular injection for 5 days along with faropenem and cefuroxime axetil tablets for 14 days. He initially started recovering but returned with pustular discharge from the incision mark. It was decided to reinitiate the ATT-intensive phase medication for another 2 months. The patient finally recovered with complete healing of the wound. The frequent change of treating physician and misuse of antimicrobials made the diagnosis tougher, contributing to delay in the optimum therapy.
Conclusion
This case highlights the abuse of multiple steroids together in the form of stacking by a young adult, which leads to a rare serious adverse effect such as suspected tubercular reactivation.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Research funding: None declared.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors' institutional review board.
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Artikel in diesem Heft
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- Chlorpyrifos and its metabolite modulates angiogenesis in the chorioallantoic membrane of chick embryo
- Prescribing pattern of antihypertensive medication and adherence to Joint National Commission-8 guidelines in a rural tertiary care Indian teaching hospital
- Assessment of cardiac risk in chronic asymptomatic alcoholics using blood pressure and electrocardiogram, and the relation with duration of drinking
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- Miscellaneous
- Suspected reactivation of extrapulmonary tuberculosis focus after non-medical abuse of anabolic androgenic steroids: a case report
- Acknowledgment
Artikel in diesem Heft
- Minireview
- Pharmacokinetics and pharmacodynamics of mitragynine, the principle alkaloid of Mitragyna speciosa: present knowledge and future directions in perspective of pain
- Original Articles
- Trehalose protects against spinal cord injury through regulating heat shock proteins 27 and 70 and caspase-3 genes expression
- Evaluation of cytogenotoxic potential of Morinda lucida leaf extract on Swiss albino male mice using two bioassays
- Acute and subacute toxicity evaluation of calcium carbide and ethylene glycol in Wistar albino rats
- Evaluation of the possible hepatotoxic and nephrotoxic potentials of the Averrhoa carambola juice extract in female albino rats
- Chlorpyrifos and its metabolite modulates angiogenesis in the chorioallantoic membrane of chick embryo
- Prescribing pattern of antihypertensive medication and adherence to Joint National Commission-8 guidelines in a rural tertiary care Indian teaching hospital
- Assessment of cardiac risk in chronic asymptomatic alcoholics using blood pressure and electrocardiogram, and the relation with duration of drinking
- Effect of ghrelin on VEGF-B and connexin-43 in a rat model of doxorubicin-induced cardiomyopathy
- In vitro antioxidant and enzyme inhibitory properties of the n-butanol fraction of Senna podocarpa (Guill. and Perr.) leaf
- Blood pressure-reducing activity of Gongronema latifolium Benth. (Apocynaeceae) and the identification of its main phytochemicals by UHPLC Q-Orbitrap mass spectrometry
- Evaluation of the anticonvulsant and anxiolytic-like activities of aqueous leaf extract of Cymbopogon citratus in mice
- Terpenoids and phytosteroids isolated from Commelina benghalensis Linn. with antioxidant activity
- Miscellaneous
- Suspected reactivation of extrapulmonary tuberculosis focus after non-medical abuse of anabolic androgenic steroids: a case report
- Acknowledgment
