title: Tuberculous cellulitis in a patient with chronic kidney disease and polymyalgia rheumatica.
abstract: An 89-year-old man with advanced renal failure, polymyalgia rheumatica and a past history of tuberculosis was admitted with a high fever. Erythema and swelling appeared in the femoral region. Since the cellulitis failed to respond to antibiotic therapy, a skin biopsy was performed. The specimen showed the presence of epithelioid cell granuloma and panniculitis. Acid-fast organisms were found on Ziehl-Neelsen staining. A polymerase chain reaction test of tuberculosis was positive. Although a diagnosis of miliary tuberculosis was suggested, examinations of a bone marrow biopsy and fundoscopy revealed normal results. The patient's symptoms improved following treatment with isoniazid, rifampicin and ethambutol. This case represents an unusual presentation of tuberculous cellulitis in an immunocompromised patient.
authors.affiliation: Department of Internal Medicine, Mishuku Hospital, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Daido-Horiuchi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fujii
authors.forename: Satoshi
authors.initials: S
authors.lastname: Oshima
authors.forename: Toshiro
authors.initials: T
authors.lastname: Kondo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D002481:Cellulitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D011111:Polymyalgia Rheumatica / Q000150:complications*; D014382:Tuberculosis, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents