medigraphic.com
ISSN 0210-5187 (Electronic)

2017, Number 2

<< Back Next >>

Med Cutan Iber Lat Am 2017; 45 (2)

Metastatic tuberculous abscess of the thorax

Medina-Castill DE, Aguilar-Medina DA, Pérez-López JA, Arenas-Guzmán R

Language: English
References: 10
Page: 131-133
PDF size: 325.52 Kb.


ABSTRACT

We present a 47 year-old male, with a six year history of a purulent ulcer at the parasternal region, taking antimicrobials drugs prescribed by the Pneumology Department with clinical diagnosis of actinomycosis. Skin biopsy showed a granulomatous infiltrate with giant multinucleated cells, and a mycobacteria was cultured in Löwenstein-Jensen. Polymerase chain reaction was positive for Mycobacterium tuberculosis. Mantoux test was 15 mm. Chest radiography showed abatement of both hemidiaphragms with right hilar shadows, right basal reticular infiltrate and ipsilateral apical signs. Culture was negative and no evidence of acid-fast bacilli on sputum and urine samples. HIV was no reactive. Improvement was observed after therapy with conventional treatment. Based on the clinical features and laboratory investigations, a diagnosis of tuberculous gumma was made. Tuberculous gumma or metastatic tuberculous abcess is a rare form of cutaneous tuberculosis and should be included in the differential diagnosis of chronic cutaneous abcesses.


REFERENCES

  1. Global Tuberculosis Report 2016, Available in: www.who.int/tb/data

  2. Figueiredo AR, Ferraz CE, De Oliveira MH, Gomes SP, Silveira MV. Cutaneous tuberculosis: epidemiologic, etiophatogenic and clinical aspects-Part I. An Bras Dermatol. 2014; 89: 219-229.

  3. Puri N. A clinical and histopathological profi le of patients with cutaneous tuberculosis. Indian J Dermatol. 2011; 56: 550-552.

  4. Bravo FG, Gotuzzo E. Cutaneous tuberculosis. Clin Dermatol. 2007; 25: 173-180.

  5. Dekeyzer S, Moerman F, Callens S, Vandekerckhove L. Cutaneous metastasic tuberculous abcess in a patient with cervico-mediastinal lymphatic tuberculosis. Acta Clin Belg. 2013; 68: 34-36.

  6. Marco A, Solé R, Raquer E, Aranda M. Goma o absceso tuberculoso metastásico como diagnóstico inicial de tuberculosis en un paciente inmunocompetente: una presentación inusual. Rev Esp Sanid Penit. 2014; 16: 59-62.

  7. Hernández SA, Herrera GN, Cazarez F, Mercadillo PP, Olivera DH, Escobar-Gutierrez A et al. Skin biopsy: a pillar in the identifi cation of cutaneous Mycobacterium tuberculosis infection. J Infect Dev Ctries. 2012; 6: 626-631.

  8. Morris BS, Maheshwari M, Chalwa A. Chest wall tuberculosis: a review of CT appearances. Br J Radiol. 2004; 77: 449-457.

  9. Pacheco C, Silva E, Miranda J, Duarte R. Cutaneous tuberculosis as metastatic tuberculous abscess. J Bras Pneumol. 2015; 41: 200-202.

  10. van Zyl L, du Plessis J, Viljoen J. Cutaneous tuberculosis overview and current treatment regimens. Tuberculosis (Edinb). 2015; 95 (6): 629-638.




2020     |     www.medigraphic.com