Unveiling rifampicin-resistant tuberculosis: A rare presentation as breast abscess in a 48-year-old patient-A case report

Tuberculous mastitis (TM) is a rare manifestation of tuberculosis (TB) that presents challenges in diagnosis and management. We present a case of a 48-year-old female enrolled in the endTB-Q trial who developed rifampicin-resistant TM, masquerading as a breast abscess. Despite a history of drug-sensitive TB and adherence to the antitubercular drug regimen, the patient later developed a breast lump during the trial. Imaging revealed an ill-defined lesion in the right breast, which was later confirmed as tuberculosis through molecular testing. Rifampicin resistance was detected, requiring a tailored treatment approach. The patient responded well to antitubercular therapy and lumpectomy. This highlights the importance of vigilance in diagnosing extrapulmonary TB manifestations, particularly in high TB burden settings. This case underscores the need for multidisciplinary management strategy for atypical presentations of TB.