A lady patient of age 35 ...

An Interesting Case for learning
History- A lady patient of age 35 comes in the clinic with looking like sebaceous cyst as some thing oozes out most often, she was pregnant- thinking it to be as usual a case of sebaceous cyst she was advised minor surgery, but she refused and went away
After 15 days she came back with that lesion much bigger and like an abscess, she was advised minor surgery. This time she had aborted by chance . It was her third pregnancy.
I duly operated with incision, I was surprised to find very little pus and no cyst like cheesy material, still she was dressed for some days with medicines cover, to my surprise after second dressing some fresh pus on pressure came out every time.
Very unusual of such kind of pus without pain and wound healing from base. I was astonished and in trouble. She was keeping a lot of patience. This lesion was in the middle over thoracic spine. An idea of cold abscess came to mind. Made her understand me.
Her X-ray came normal but 2 days earlier MONTOUX was much positive 25x48. Dressing is advised alternate days but has not turned up so far. immediately have started anti kochs . Further tests for culture sensitivity from pus have been send along with x ne xpert for further strengthening the case. She had pulmonary koch’s 3 yrs back as duly treated. Now thought of getting an X-ray done for lesion if suspected sebaceous cyst.