Tuberculosis cutis miliaris disseminata as a manifestation of miliary tuberculosis: literature review and report of a case of recurrent skin lesions.
The development of severe adverse reactions to antituberculous drugs in a patient with miliary tuberculosis led to unorthodox, suboptimal antituberculous therapy. The patient's failure to respond to therapy was discovered when acid-fast bacilli were detected in new skin lesions. Such lesions have been described in the literature as tuberculosis cutis miliaris disseminata; 24 cases (in addition to that described herein) have been reported thus far. The patient eventually recovered completely after detection and drainage of a large retrofascial tuberculous abscess. This case illustrates the importance of careful examination of the skin in clinical medicine, as tuberculosis cutis miliaris disseminata is an easily overlooked sign of miliary tuberculosis.
Rietbroek
R C
RC
Department of Medicine, University Hospital Nijmegen, The Netherlands.
Dahlmans
R P
RP
Smedts
F
F
Frantzen
P J
PJ
Koopman
R J
RJ
van der Meer
J W
JW
D000038:Abscess / Q000601:surgery; D002081:Buttocks; D003128:Coma / Q000139:chemically induced; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D012008:Recurrence; D012867:Skin / Q000473:pathology*; D014382:Tuberculosis, Cutaneous / Q000188:drug therapy / Q000473:pathology*; D014391:Tuberculosis, Miliary / Q000188:drug therapy / Q000473:pathology*
D007538:Isoniazid