Primary extensive perianal cutaneous tuberculosis: A challenging diagnosis. Case report and a review of the literature

Takahashi, André Akira Ramos; Bassaneze, Thiago; Longo, Karina Scalabrin; Batista, Juliana Giangiardi; Waisberg, Jaques

doi:10.1016/j.bjid.2022.102722

Cited by 6 publications

(31 citation statements)

References 16 publications

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“…6,7 The diagnosis of CTB is considered challenging and is based on two criteria, either absolute or relative criteria. [1][2][3][4][5][6][7] The absolute criteria involve identifying M. tuberculosis either using culture, molecular tool such as polymerase chain reaction (PCR), or histopathologic examination. The major limitation of diagnosis is the paucibacillary nature of CTB.…”

Section: Discussionmentioning

confidence: 99%

“…(1) the varied clinical presentations of cutaneous TB; (2) the similarities in presentation between cutaneous TB and other skin diseases; and (3) the low bacillary load found in cutaneous TB. Host immunity plays an important role in determining the histopathological picture of cutaneous TB, and the hallmark picture of a typical tuberculoid granuloma which consists of epithelioid cells, lymphocytes, Langhans cell along with caseous necrosis is not present in every patient.…”

Section: Discussionmentioning

confidence: 99%

“…Mycobacterium tuberculosis infection has different clinical forms that includes pulmonary and extrapulmonary forms 1,2 . Cutaneous tuberculosis (CTB) is considered a rare form of extrapulmonary tuberculosis which may mimic various other skin dermatoses leading to a misdiagnosis, delay the case management, and eventual increase the disease morbidity 3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…Mycobacterium tuberculosis infection has different clinical forms that includes pulmonary and extrapulmonary forms. 1,2 Cutaneous tuberculosis (CTB) is considered a rare form of extrapulmonary tuberculosis which may mimic various other skin dermatoses leading to a misdiagnosis, delay the case management, and eventual increase the disease morbidity. 3,4 For CTB, the major challenge is the delay in initiating the medical therapy combined with the long duration of the disease, which may become complicated with carcinoma and disfiguring scars.…”

Section: Introductionmentioning

confidence: 99%

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Cutaneous tuberculosis of the foot clinically mimicking mycetoma: A case report

Ahmed

Hagelnur

Eltigani

et al. 2023

Clinical Case Reports

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Key Clinical Message In a resource‐limited setting such as Sudan, where diagnostic and surveillance capacities are limited and several dermal diseases with similar clinical presentation are endemic, further precautious must taking into account. Abstract Cutaneous tuberculosis (CTB) is a rare infection caused by Mycobacterium tuberculosis. Atypical clinical presentations of CTB may resemble other skin neglected diseases. For definitive diagnosis, we require a holistic diagnostic approach including clinical examination and deployment of laboratory investigations including microbial culture, histopathological, and molecular examinations of the proper samples per test. In this communication, we report a case of CTB that was initially misidentified clinically as mycetoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cutaneous tuberculosis of the foot clinically mimicking mycetoma: A case report

Ahmed

Hagelnur

Eltigani

et al. 2023

Clinical Case Reports

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“…1,2 Pulmonary disease is the most frequent manifestation. 1 Extrapulmonary tuberculosis accounts for at least 15% of all cases and gastrointestinal tuberculosis accounts for less than 1% of all cases. 1,2 The disease can involve any part of the gastrointestinal system.…”

Section: Introductionmentioning

confidence: 99%

Perianal tuberculosis presenting as a Fournier's gangrene

Lalanda,

Barão,

Draiblate

et al. 2024

Clinical Case Reports

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Key Clinical MessageIn the setting of Fournier's gangrene, atypical clinical manifestations and complications in an immunocompetent patient warrant consideration of perineal tuberculosis as a potential underlying cause.AbstractTuberculosis cutis orificialis is a rare form of extrapulmonary tuberculosis that affects the perianal region. Fournier's gangrene is an aggressive necrotizing fasciitis that primarily involves the perianal area and external genitalia. A previously healthy 38‐year‐old man presented with a left perianal abscess. His condition deteriorated, leading to septic shock and multiorgan dysfunction syndrome. A CT scan displayed extensive necrotizing fasciitis. Treatment included broad‐spectrum antibiotics, numerous surgical perineal debridements, a transverse loop colostomy, and hyperbaric oxygen therapy. We believe the patient had pre‐existing asymptomatic, non‐diagnosed perianal tuberculosis, and a subsequent bacterial superinfection resulted in a perineal local abscess that progressed to severe Fournier's gangrene. The diagnosis of tuberculosis was confirmed through positive cultures and molecular identification in perineal biopsies. The patient experienced a complex clinical course with complications such as myocardial necrosis, acute respiratory distress syndrome, rhabdomyolysis with severe critical illness polyneuromyopathy and internal jugular thrombosis. Fournier's gangrene resulted in air dissection throughout the perineal fasciae, extending to the abdominal wall muscles resulting in an infected extraperitoneal spontaneous hematoma, probably caused by therapeutic anticoagulation. An extraperitoneal surgical drainage was performed. This case emphasizes the complexities in diagnosing and managing both perianal tuberculosis and Fournier's gangrene.

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