A Case of Extrapulmonary Tuberculosis in an Immunocompetent Patient

Abstract

Background: Primary cutaneous tuberculosis is a relatively uncommon manifestation especially in immunocompetent patients and it may occur in countries where tuberculosis is endemic. Findings: In this report, we described a case of a 20-year-old male presenting ulcerative lesions in the left foot and in the right hand caused by Mycobacterium tuberculosis without past history of pulmonary tuberculosis. Conclusion: This case report emphasizes the importance to suspect of a tuberculosis infection in all patients with skin lesions who do not respond to antibiotic treatment.

Primary Cutaneous Tuberculosis Misdiagnosed as a Deep Mycotic Infection

“…In our patient, the lesion was misdiagnosed as a bacterial infection and then as a deep mycotic infection. We suspected the diagnosis due to a poor response to previous treatments and the mycobacterial infection was finally confirmed by isolation of M. tuberculosis complex in the culture (3).…”

“…In PCTB, at first an ulcer with a granular, deep red basis and indurated edges develops, then its size may be increased and the surrounding skin may have a reddish-blue hue (1). The clinical features vary markedly, so the diagnosis may be delayed (3,5,6).…”

“…Cutaneous tuberculosis (TB) is an extrapulmonary manifestation that includes < 2% of all cases of TB; the disease is therefore often misdiagnosed (1,2). Primary cutaneous infection mainly results from direct inoculation of bacilli into the skin and it is thought to be mostly an occupational disease and more frequent in children (3). This report describes a case of primary cutaneous TB (PCTB).…”

Perianal tuberculosis in an immunocompetent patient

“…3 Due to its heterogeneous clinical presentation, the diagnosis of cutaneous TB is challenging, requiring a high level of suspicion. 4 This is a case of a 56-year-old male patient from southern Brazil. The patient worked as a jockey, now presenting with verrucous perianal lesions for 6 months.…”

“…5 Cutaneous TB often affects immunocompromised patients. 4 Patients with perianal TB usually harbour the disease for a long time before diagnosis and onset of treatment, as perianal TB is frequently mistaken for other more common perianal conditions, such as Crohn's disease. 3,6 For that reason, most patients have chronic and recurrent lesions that have failed to respond to multiple drug and surgical treatments.…”