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BMC Infectious Diseases (2026) 26:26 [https://doi.org/10.1186/s12879-025-12270-x](https://doi.org/10.1186/s12879-025-12270-x)  \nBMC Infectious Diseases  \nCASE REPORT Open Access  \nMultidrug-resistant tuberculosis involving breast and adnexa uteri: a case report and literature review  \nXiao-Ya Cui 1, Gui-Qing He1, Ji-Chan Shi 1, Yi-Tong Huang2, Zhi-Ruo Lin 1, Lian-Peng Wu3 and Xian-Gao Jiang1*  \nAbstract  \nBackground Multidrug-resistant tuberculosis (MDR-TB) remains a major global public health challenge, whereas extrapulmonary involvement is relatively uncommon. Here, we report a rare case of disseminated MDR-TB presenting with simultaneous involvement of multiple organs. A review of the literature identified a single previously reported case of MDR-TB of the breast and six cases involving the female reproductive system, and none exhibited a pattern of organ involvement or microbiological characteristics comparable to those observed in the present case.  \nCase presentation A 33-year-old woman presented with a five-month history of breast swelling and pain, accompanied by fever for three days. Microbiological testing confirmed disseminated MDR-TB with simultaneous involvement of the lungs, breast, and adnexa uteri. The patient showed marked clinical improvement following individualised, guideline-based anti-tuberculosis therapy.  \nConclusion This case highlights the exceptional rarity of MDR-TB with atypical multi-organ involvement and underscores the importance of maintaining high clinical suspicion for tuberculosis in uncommon sites. Early implementation of comprehensive microbiological and drug resistance assessments, followed by appropriate standardised therapy, is essential to prevent diagnostic delay and improve clinical outcomes.  \nKeywords Multidrug-resistant tuberculosis, Breast tuberculosis, Female genital tuberculosis, Disseminated tuberculosis  \n*Correspondence:  \nXian-Gao Jiang  \n[xiangaojiang@wmu.edu.cn](xiangaojiang@wmu.edu.cn)  \n1Department of Infectious Disease, Wenzhou Central Hospital, Wenzhou Central Hospital, Affiliated to Wenzhou Medical University, Wenzhou Sixth People’s Hospital, Wenzhou, Zhejiang 325000, China  \n2Department of Gynaecology and Oncology, Wenzhou Central Hospital, Wenzhou Central Hospital, Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang 325000, China  \n3Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, Wenzhou Central Hospital, Affiliated to Wenzhou Medical University, Wenzhou, Zhejiang 325000, China  \nBackground  \nMDR-TB is defined as pulmonary tuberculosis caused by Mycobacterium tuberculosis (MTB) strains that are resistant to both isoniazid (INH) and rifampicin (RIF), which are two primary first-line anti-tuberculosis drugs [1]. The Global Tuberculosis Report 2024, published by the World Health Organisation, indicates that by 2023, there were 400,000 cases of multidrug-or rifampicin-resistant tuberculosis (MDR/RR-TB) globally, with approximately 29,000 cases in China, representing 7.3% of the global burden and ranking fourth worldwide [2]. Consequently, MDR-TB has become a major public health challenge in global tuberculosis control.  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not pe","cbCaigQUI2myBTP5","https://ap.wps.com/l/cbCaigQUI2myBTP5","pdf",3848047,"English","# Abstract\n## Background\n## Case presentation\n## Conclusion\n# Background\n# Case presentation","[{\"question\":\"Why is extrapulmonary MDR-TB difficult to recognize in uncommon sites?\",\"answer\":\"Extrapulmonary involvement is relatively uncommon, and breast and female genital tuberculosis often lack specific clinical manifestations, mimicking other diseases. This can lead to misdiagnosis and diagnostic delay.\"},{\"question\":\"What organs were involved in the reported case?\",\"answer\":\"Microbiological testing confirmed disseminated MDR-TB with simultaneous involvement of the lungs, the breast, and the adnexa uteri.\"},{\"question\":\"How was the patient treated and what was the outcome?\",\"answer\":\"The patient received individualized, guideline-based anti-tuberculosis therapy and showed marked clinical improvement.\"}]","Multidrug-resistant tuberculosis involving breast and adnexa uteri - a case report and literature review | PDF",1790750432,18,{"code":4,"msg":82,"data":99},[100,104,108,112,117,122,125,130,135,138,141],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},"Exam",70,"exam",{"id":113,"doc_module":4,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},5,"Comic",60,"comic",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},6,"Technology",50,"technology",{"id":86,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":123,"slug":124},40,"healthcare",{"id":126,"doc_module":4,"doc_module_name":25,"category_name":127,"show_sort_weight":128,"slug":129},8,"Research & Report",30,"research-report",{"id":131,"doc_module":4,"doc_module_name":25,"category_name":132,"show_sort_weight":133,"slug":134},9,"Religion & Spirituality",20,"religion-spirituality",{"id":133,"doc_module":4,"doc_module_name":25,"category_name":136,"show_sort_weight":133,"slug":137},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":139,"show_sort_weight":55,"slug":140},"Lifestyle","lifestyle",{"id":142,"doc_module":4,"doc_module_name":25,"category_name":143,"show_sort_weight":113,"slug":144},19,"General","general"]