Topic:

Tuberculosis and other mycobacterial infections

Abstract No.:

ISE.396

Title:

Mycobacterium tuberculosis infection with cutaneous abcess and osteomylitis

Author(s):

K. Esalatmanesh¹, Z. Soleimani²; ¹medical science university, internal medicine, Kashan, ESFAHAN/IR, ²infectios disease department, Kashan/IR

Abstract:

Background: Mycobacterium tuberculosis is a multi-systemic infection.Extrapulmonary manifestation and pleural tuberculosis occurs in 5% of tuberculosis. M tuberculosis is rarely associated with cutaneous or osteoarticular infection. Overall cutaneous tuberculosis accounts for 14% of all cases of tuberculosis.
Methods: Here in a case of mycobacterium tuberculosis infection presenting with cutaneous abscess,osteomylitis is reported. A 16 year old Afghanian female immigrant presented to her internist with a 4x3 cm right ankle and foot abscess and cellulites, 3 x 3 cm left palmar abcess, 5x6 cm sternal abcess and cellulitis which had been present for 2 months. Foot X Ray reveal osteomylitis in third metatars and coniform. Spiral CT scan of the chest demonstrated a low density area (3.0 x 5.2 cm with central low density, suggestive of necrosis) with irregular border and enhancement inside the R.pectoralis major muscle with partial extension to the intra thorasic area. Purified protein derivative (PPD) was 22mm. Biopsy of soft tissue from foot (and culture) was negative for mycobacterium and fungi and nocardia. Biopsy from bone reveal: growth of acid fast bacill after 45 days. The patient responded favorably to standard anti tuberculous regimen. Our case is very good after 12 mounths.
Results: This is case report.
Conclusion: Cutaneous tuberculosis should be included in the differential diagnosis of patients with cutaneous abscesses or musculoskeletal complaints, particularly in high risk populations such as immigrants from endemic regions and immunosupressed patients. She underwent to cure and improvement with anti tuberculous regimen.