[Atypical erythema induratum Bazin with tuberculous osteomyelitis].
Diagnosis of all types of cutaneous tuberculosis is challenging because the clinical picture of these diseases is highly variable. We describe the case of a 79-year old woman with an atypical presentation of Erythema induratum Bazin (EIB) on the chest and left arm in association with a tuberculous osteomyelitis of the left olecranon. Surprisingly, M. tuberculosis grew also from biopsies of the EIB-lesions. This contradicts the conventional view that considers EIB (a tuberculid) to be caused by a hypersensitivity reaction to mycobacteria. The presented case supports the hypothesis that EIB may also be caused by hematogenous or lymphatic spread of viable M. tuberculosis.
Degonda Halter
M
M
Klinik für Infektiologie und Spitalhygiene, Universitätsspital, 4031, Basel. sbassetti@uhbs.ch
Nebiker
P
P
Hug
B
B
Oberholzer
M
M
Flückiger
U
U
Bassetti
S
S
D000368:Aged; D003937:Diagnosis, Differential; D004891:Erythema Induratum / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D010019:Osteomyelitis / Q000175:diagnosis* / Q000628:therapy; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000628:therapy