Non-respiratory tuberculosis with Mycobacterium tuberculosis after penetrating lesions of the skin: five case histories.
Tuberculosis is primarily transmitted from person to person via the respiratory route. We describe five cases of patients who developed tuberculosis at the site of a skin injury: three after being treated repeatedly with local corticosteroids via intramuscular injections, and two who cut themselves accidentally with a knife. All cultures yielded normal-sensitive Mycobacterium tuberculosis, and all patients responded well to anti-tuberculosis treatment. These unusual manifestations of non-respiratory tuberculosis may support the assumption that persistent, painful, reddish and/or fistulous areas of the skin might also indicate an infection caused by M. tuberculosis, via either reactivation of pulmonary tuberculosis or primary infection with M. tuberculosis by cutaneous transmission.
de Jong
J W
JW
Department of Internal Medicine, Cardiology and Pulmonology, St. Lucas Hospital, Winschoten, The Netherlands. jwdj@dds.nl
van Altena
R
R
D000287:Administration, Topical; D000293:Adolescent; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001416:Back Pain / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D007270:Injections, Intra-Articular / Q000009:adverse effects*; D007273:Injections, Intramuscular / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal; D014376:Tuberculosis / Q000209:etiology / Q000635:transmission*; D014382:Tuberculosis, Cutaneous / Q000209:etiology / Q000635:transmission; D014394:Tuberculosis, Osteoarticular / Q000209:etiology / Q000635:transmission; D014950:Wounds, Penetrating / Q000382:microbiology*
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids