Author(s): M. Lavanya, B. Swathi, K. Venkatram Reddy, R. Sathya Narayana Moorthy, Gaddam Rama Krishna Reddy

A 21-year-old male came with complaints of left knee pain with progressive swelling for 3 months. Patient had history of 5 Kg weight loss in past 3 months with intermittent fever. There was history of cough without sputum. Patient belonged to low socio-economic status with no family history of tuberculosis. On local examination, left knee swelling with mild tenderness were noted. There were no external discharging sinuses. On palpation there is doughy feel of the swelling with tenderness over patella. There was normal range of movements of the left knee joint. Laboratory investigations revealed hemoglobin level of 11 gm /dl, total leucocyte count of 8700 /mm3 with lymphocytosis erythrocyte sedimentation rate was 48 mm (Westergren) in the first hour. C-reactive protein was 11 mg/L. Serology for HIV & HBsAg were negative. Ultra sound abdomen and pelvis was done which shows bilateral inguinal lymphadenopathy.