Concomitant cutaneous metastatic tuberculous abscesses and multifocal skeletal tuberculosis

Abstract

Tuberculosis, one of the oldest diseases known to affect humans is caused by the bacteria mycobacterium tuberculosis. The disease usually affects the lungs, although, in up to one third of cases, other organs are involved. Metastatic tuberculosis abscess is a rare form of skin tuberculosis. It is characterized by nodule and abscess formation throughout the body after hematogenous spread of mycobacterium tuberculosis from a primary focus during a period of impaired immunity. Tuberculosis osteomyelitis is also a rare form of extrapulmonary tuberculosis in pediatric age group. Skeletal tuberculosis pathogenesis is related to reactivation of hematogenous foci or spread from adjacent paravertebral lymph nodes. Weight-bearing joints are affected most commonly. Bilateral hand and foot bone involvement is rarely reported. We present a five-year-old girl with two very rare presentations of the disease such as osteomyelitis and metastatic skin abscess.

Delay in diagnosis of generalized miliary tuberculosis with osseo-articular involvement: a case report

“…It is possible that an initial pulmonary infection resulted in miliary multisystem tuberculosis via hematogenous spread. The histological features of large areas of necrosis and lymphocytic infiltration has been reported previously from tuberculous abscesses [3]. Histological features typical of granuloma or evidence of AFB are not always detected in biopsies from such abscesses.…”

Chronic osteomyelitis of humerus presenting as scrofuloderma

“…[10] In skeletal tuberculosis the clinical findings may not be specific and in many cases the radiolodical features resemble pyogenic osteomyelitis, so it is frequently neglected or misdiagnosed. [2] Spine and hip are the most common sites of osteoatrticular tuberculosis, but tuberculosis of humerus is less common. In our case, scrofuloderma was confirmed by the presence of acid fast bacilli on culture which was confirmed by PCR and presence of epithelioid granulomas on histopathologic examination.…”

“…[1] It is a form of extrapulmonary tuberculosis occuring in 1% of all tuberculosis cases. [2] Many types of cutaneous tuberculosis like lupus vulgaris, scrofuloderma, tuberculosis verrucosa cutis, tuberculous gumma, orificial tuberculosis etc., are described. [34] Scrofuloderma is also known as “Tuberculosis colli quativa cutis” resulting from direct extension of underlying tuberculous foci such as lymphnode, bone or joint to the overlying skin.…”

Cutaneous and Skeletal Simultaneous Locations as a Rare Clinical Presentation of Tuberculosis

“…Tuberculosis is one of the most ancient diseases across the world, caused by Mycobacterium tuberculosis , generally involving the lung where extra-pulmonary tuberculosis involvement occurs in 1/3 of the cases [ 1 , 2 ].…”

“…Musculoskeletal tuberculosis represents 1–3% of all cases, with the spine being most frequently affected, followed by the hip and knee [ 1 , 2 ]. Cutaneous tuberculosis occurs in 1% of all tuberculosis cases and can mimic the clinical features of many other skin diseases [ 2 , 4 – 6 ].…”