Primary inoculation tuberculosis: a report of a rare entity

Abstract

Primary inoculation tuberculosis is an exogenous infection resulting from direct inoculation of bacteria into individuals with no acquired immunity to the organism. We report a 63-year-old male patient who was diagnosed with primary inoculation tuberculosis on the basis of clinical appearance and histopathological examination. The fi ndings from this case emphasize the importance of clinical and histopathological fi ndings in this rarely seen form of skin tuberculosis if the organism cannot be shown to grow in culture.

Tuberculosis cutánea esporotricoide en la Amazonia peruana: reporte de caso

“…g: presencia de granulomas, GMN: célula gigante multinucleada. observar en población infantil y en jóvenes (8,9) cuyo diagnóstico inicial con biopsia es la presencia de alta carga de bacilos ácidos alcohol resistente (BAAR), pero en casos de larga evolución estos bacilos disminuyen, con observación de granuloma epitelioide con células gigantes tipo Langhans (5,(10)(11)(12) . Algunas veces la coloración especial de Ziehl-Neelsen en muestras de esputo no revela la presencia del microorganismo en la muestra (8)(9)(13)(14)(15) , como se dio en este caso.…”

“…Se presenta con lesión nodular en la cara o en las extremidades superiores o inferiores, que eventualmente se ulcera luego de 2 o 3 semanas, además se presenta linfadenopatía no dolorosa asociada a complejo linfocutáneo análogo al complejo de Ghon en infección pulmonar (4) . El diagnóstico es por biopsia temprana, donde se muestra un infiltrado neutrofílico que evoluciona para producir un granuloma tuberculoso necrosante con presencia de múltiples bacilos ácido alcohol resistentes (BAAR) (5,6).…”

Lupus Vulgaris of the External Nose in a Paediatric Patient: A Case Report from Muhimbili National Hospital, Tanzania

“…[4] Following exogenous inoculation, lupus vulgaris may manifest at the site of BCG vaccination and may also be acquired endogenously through reactivation of dormant or persistent Mycobacterium tuberculosis after a reduction of cell-mediated immunity. [1,2,7] Establishing the diagnosis of lupus vulgaris is not a straightforward task and clinicians and Otorhinolaryngologists need to have a high index of suspicion. The diagnosis should mainly be based on clinico-histopathological findings and retrospective review of response to treatment; [1] relying on tissue culture and polymerase chain reaction often is of no help because of low yield.…”