An evolving presentation of cutaneous tuberculosis

Brown, Ashley E.; Ibraheim, Marina Kristy; Petersen, Erik; Swaby, Michael; Pinney, Sarah S.

doi:10.5070/d3268049889

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Although only a few cases with lesions for more than 20 years have been reported in the medical literature, no functional disability has been detected. However, it is still important to highlight that this disease progresses slowly, and persists if not properly treated, 16 , 17 as observed in this patient that coexisted with the etiologic agent for more than 50% of his life span.…”

Section: Discussionmentioning

confidence: 86%

A case of tuberculosis verrucosa cutis in Brazil undiagnosed for 15 years

Wedy

Passero

Criado

et al. 2021

The Brazilian Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 86%

A case of tuberculosis verrucosa cutis in Brazil undiagnosed for 15 years

Wedy

Passero

Criado

et al. 2021

The Brazilian Journal of Infectious Diseases

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“…Cutaneous TB can be classified broadly into two distinct categories: paucibacillary tuberculids and true cutaneous TB. 15 , 16 Tuberculids are a hypersensitivity reaction to M. tuberculosis that occur in patients with a moderate-to-high level of immunity against the organism. 17 Tuberculids are characterized by granulomatous inflammation on histopathology with the absence of M. tuberculosis on tissue stain or culture, while true cutaneous TB will identify organisms on stain or culture.…”

Section: Discussionmentioning

confidence: 99%

Non-pulmonary Disseminated Tuberculosis Complicated by Constrictive Pericarditis and Cutaneous Gumma

et al. 2022

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A 23-year-old previously healthy male presented to the hospital with symptoms of heart failure. He was diagnosed with pericarditis and found to have a reduced left ventricular ejection fraction of 25%. He was noted to have mediastinal lymphadenopathy. Pulmonary and abdominal sampling were non-diagnostic for infection, autoimmune disease, or malignancy. A QuantiFERON Gold returned positive. After a thorough travel history and detailed exam, the patient was diagnosed with disseminated tuberculosis after the discovery of a cutaneous gumma that was found to have acid-fast bacilli present on biopsy with Fite’s stain. 18 F-FDG PET CT and cardiac MRI were pursued given that pericardial and myocardial biopsy could not be safely performed due to the patient’s hemodynamics. 18 F-FDG PET CT and cardiac MRI did not demonstrate any myocardial pathology responsible for the left ventricular ejection fraction. This case highlights that pulmonary involvement is not necessary for disseminated TB, Fite’s stain may be used to identify M. tuberculosis , and that cardiac MRI and 18 F-FDG PET CT may be useful to delineate myocardial involvement in high-risk situations.

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“…Histopathology is not specific, as it shows granulomatous lesions both in true infections and in immunological reactions. The sensitivity of Ziehl-Nielsen AFB stain is low in CTB [2,22]. Thus, culture and amplification of M. tuberculosis DNA by PCR in skin biopsies are the gold standard for diagnosis [11].…”

Section: Key Pointsmentioning

confidence: 99%

Mycobacterial skin infection

Giannotti

Gregori

Matteelli

et al. 2022

Current Opinion in Infectious Diseases

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Purpose of review The aim of this article is to review the most recent evidences concerning mycobacterial skin infections, limiting the period of literature research to 2020--2021. Recent findings Mycobacterial skin infections include a heterogeneous group of cutaneous diseases. Cutaneous tuberculosis is usually the result of hematogenous dissemination or spread from underlying foci and it must be distinguished from tuberculids, resulting from the immunological reaction to Mycobacterium tuberculosis antigens. Leprosy prevalence was drastically reduced after introduction of multidrug therapy in the 1980 s, but cases are still reported due to underdiagnosis, and animal and environmental reservoirs. Recent advances concentrate in the diagnostic field. Specific guidelines for the treatment of nontuberculous mycobacteria skin infections are missing and surgical procedures may be required. Prognosis is better as compared to nontuberculous mycobacteria lung disease. Rapid laboratory-confirmed diagnosis of Buruli ulcer may be achieved by the IS2404 PCR. Among new drugs, telacebec is promising in terms of potency, shorter duration and tolerability in animal studies. A clinical trial in humans is planned. Summary Mycobacterial cutaneous lesions are nonpathognomonic and clinical suspicion must be confirmed by culture or molecular detection. Long-course multidrug treatment is required based on susceptibility tests. Surgical intervention may also be required. Rehabilitation and psychosocial support reduce long-term physical and mental consequences mostly in Buruli ulcer and leprosy.

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An evolving presentation of cutaneous tuberculosis

Cited by 4 publications

References 7 publications

A case of tuberculosis verrucosa cutis in Brazil undiagnosed for 15 years

A case of tuberculosis verrucosa cutis in Brazil undiagnosed for 15 years

Non-pulmonary Disseminated Tuberculosis Complicated by Constrictive Pericarditis and Cutaneous Gumma

Mycobacterial skin infection

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