title: Non-respiratory tuberculosis with Mycobacterium tuberculosis after penetrating lesions of the skin: five case histories.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Cardiology and Pulmonology, St. Lucas Hospital, Winschoten, The Netherlands. jwdj@dds.nl
authors.forename: J W
authors.initials: JW
authors.lastname: de Jong
authors.forename: R
authors.initials: R
authors.lastname: van Altena
mesh_terms: 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*
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids