Tuberculosis Cutis Miliaris Disseminata as a Manifestation of Miliary Tuberculosis: Literature Review and Report of a Case of Recurrent Skin Lesions

Rietbroek, R. C.; Dahlmans, R. P. M.; Smedts, Frank; Frantzen, P. J.; Koopman, Roland J.J.; Meer, J.W.M. van der

doi:10.1093/clinids/13.2.265

Cited by 59 publications

(20 citation statements)

References 12 publications

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“…Including the two cases presented here, a total of 143 episodes of paradoxical response was found in the English literature, of which 122 episodes in 104 patients matched our definition (Table 1) [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,…”

Section: Literature Reviewmentioning

confidence: 68%

“…For lesions in superficial sites, such as peripheral lymph nodes [6,23,42,43], skin and soft tissues [44,45,46,47,48], and bone and tendons [36,43,49], the clinical symptoms of paradoxical deterioration are usually obvious. Involvement of lymph nodes during paradoxical deterioration (4%) in our series was significantly less common than that in HIV-positive patients (41%) [57].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Spectrum of Paradoxical Deterioration During Antituberculosis Therapy in Non-HIV-Infected Patients

Cheng

Lee

et al. 2002

European Journal of Clinical Microbiology & Infectious Dise

305

233

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Paradoxical deterioration during antituberculosis therapy, defined as the clinical or radiological worsening of pre-existing tuberculous lesions or the development of new lesions in a patient who initially improves, remains a diagnostic dilemma. Although different clinical presentations of paradoxical response have been described, a systematic analysis of the entity in non-HIV-infected patients is lacking. Reported here are two cases of paradoxical deterioration in which sequential changes in lymphocyte counts and tuberculin skin test results are emphasized. In addition, 120 episodes of paradoxical response after antituberculosis treatment were reviewed. Of the total 122 episodes, 101 (82.8%) were associated with extrapulmonary tuberculosis. The median time from commencement of treatment to paradoxical deterioration was 60 days. The median time to onset of central nervous system manifestations (63 days) was longer than the time to onset of manifestations at other sites (56 days) ( P=0.02). Development of new lesions in anatomical sites other than those observed at initial presentation was observed in 31 (25.4%) episodes. A surge in the lymphocyte count, accompanied by an exaggerated tuberculin skin reaction, was observed in our patients during the paradoxical deterioration, analogous to the findings in HIV-positive patients. Treatment of the paradoxical response included surgical intervention (60.7%) and administration of steroids (39.3%). The use of steroids appeared to be safe in this series, as 95% of the Mycobacterium tuberculosis isolates were susceptible to first-line antituberculosis therapy.

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Section: Literature Reviewmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Clinical Spectrum of Paradoxical Deterioration During Antituberculosis Therapy in Non-HIV-Infected Patients

Cheng

Lee

et al. 2002

European Journal of Clinical Microbiology & Infectious Dise

305

233

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“…In a review published in 1991, Rietbroek et al [11] described 24 cases in adult patients with virtually no underlying illnesses. Recently, such a condition tends to occur in HIV and immunocompromised adult patients [3,[6][7][8]12].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous miliary tuberculosis in a chronic kidney disease patient

2015

Journal of the American Academy of Dermatology

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“…6 It has also been described in a handful of patients with immune dysfunction secondary to malignancy, chemotherapy, or immunosuppression status post organ transplant or for treatment of autoimmune disease. [7][8][9][10] In fact, a review of the literature from 1889 to 1991 yields only 18 biopsy or culture-proven cases reported in patients older than 15 years. [7][8][9][10][11] Cutaneous miliary tuberculosis in the setting of HIV infection was first reported by Stack, Bickley, and Coppel 12 in 1990.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] In fact, a review of the literature from 1889 to 1991 yields only 18 biopsy or culture-proven cases reported in patients older than 15 years. [7][8][9][10][11] Cutaneous miliary tuberculosis in the setting of HIV infection was first reported by Stack, Bickley, and Coppel 12 in 1990. Since that time, 16 additional cases of disseminated miliary tuberculosis have been described in patients coinfected with HIV, including the two reported herein (Table I).…”

Section: Discussionmentioning

confidence: 99%