Tuberculous cellulitis in an immunocompetent patient

Abstract

Mycobacterial skin infections are rare, with a wide spectrum of clinical features in immunocompromised individuals. Overall, they represent <2% of all forms of extrapulmonary tuberculosis. Tuberculous cellulitis is considered a skin manifestation of miliary tuberculosis. We present a case of tuberculous cellulitis in an immunocompetent patient. KEYWORDS Biopsy; cellulitis; immunocompetent; Mycobacterium tuberculosis C utaneous tuberculosis is an uncommon chronic mycobacterial skin infection, comprising 1% to 2% of all extrapulmonary tuberculosis manifestations. 1,2 Recent studies show that the incidence of cutaneous tuberculosis has increased in some areas, in part due to drug-resistant mycobacteria and the HIV epidemic. 3 Tuberculous cellulitis is a rare variant of cutaneous tuberculosis that has been mostly reported in immunosuppressed patients. 4 A combination of clinical findings, histology, acidfast bacilli stain, culture, and polymerase chain reaction (PCR) assay can help clinicians in the diagnosis of tuberculous cellulitis. However, obtaining an appropriate sample significantly impacts the diagnostic yield.

A case of ulcerative tuberculous cellulitis in the setting of methotrexate-associated lymphoproliferative disorder

“…To date, there have been 7 clinical reports of tuberculous cellulitis in adult patients, including our case ( Table I ). 1 , 3 , 4 , 5 , 6 , 7 All patients were immunosuppressed. Six received steroid therapy, including 3 patients with collagen vascular disease, 4 , 5 1 with diabetes, 1 1 with chronic hepatitis, 3 and a renal transplant recipient.…”

“…Six received steroid therapy, including 3 patients with collagen vascular disease, 4 , 5 1 with diabetes, 1 1 with chronic hepatitis, 3 and a renal transplant recipient. 7 The extremities were affected in 6 of the 7 patients, 3 , 4 , 5 , 6 , 7 and most developed concomitant bacterial superinfection. Several studies have reported severe tuberculous cellulitis causing erosions and ulcers and myositis, depending on the depth of invasion.…”

“…Several studies have reported severe tuberculous cellulitis causing erosions and ulcers and myositis, depending on the depth of invasion. 5 , 6 , 7 …”

“…Several cases of atypical CTB have been reported in adults. 1 , 3 , 4 , 5 , 6 , 7 We present a rare case of ulcerative tuberculous cellulitis in a patient with methotrexate-associated lymphoproliferative disorder (MTX-LPD.)…”