title: A 7-year-old girl with multiple skin ulcers: Case report and literature review.
abstract: BACKGROUND
  There has been an increase in the number of tuberculosis (TB) cases worldwide, but TB of the skin remains rare.
  
  
  METHODS
  A case of 7-year-old girl with multiple ulcerating nodules who presented with four ulcers in the skin of the left elbow. The patient was unresponsive to broad-spectrum antibiotics treatment initially. Because of poor clinical response to conventional therapy, TB was suspected. Although tuberculin skin test was negative, positive QuantiFERON TB Gold test and clinical picture strongly indicated TB. Clinical diagnosis was confirmed by positive culture for Mycobacterium tuberculosis.
  
  
  CONCLUSIONS
  A high index of clinical suspicion is necessary to suspect TB of the skin. Positive culture remains the gold standard for diagnosis.
authors.affiliation: Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. Electronic address: emansobh2012@gmail.com.
authors.forename: Eman
authors.initials: E
authors.lastname: Sobh
authors.affiliation: Department of Pediatric Diseases, Abbassia Chest Hospital, Cairo, Egypt.
authors.forename: Amira
authors.initials: A
authors.lastname: Bahour
authors.affiliation: Department of Pathology, Abbassia Chest Hospital, Cairo, Egypt.
authors.forename: Sahar
authors.initials: S
authors.lastname: Elsayed
authors.affiliation: Department of Pediatric Diseases, Abbassia Chest Hospital, Cairo, Egypt.
authors.forename: Wegdan
authors.initials: W
authors.lastname: Amer
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification* / Q000502:physiology; D012883:Skin Ulcer / Q000382:microbiology*; D014376:Tuberculosis / Q000382:microbiology*
keywords: Cutaneous tuberculosis; Interferon-gamma release assays; Tuberculin skin test