title: 'TB or not TB?' Problems of differential diagnosis of cutaneous mycobacteriosis and tuberculosis--A Case Study and interdisciplinary discussion.
abstract: The diagnosis of cutaneous tuberculosis poses a serious challenge due to many skin diseases of different etiology resembling the lesions caused by the TB (tuberculosis) bacillus, and difficulties in confirming the disease. The presented case concerns skin lesions in a hobby aquarist stung in the finger of the left hand by a fish. The resulting inflammatory infiltration was to be cutaneous tuberculosis or mycobacteriosis caused by MOTT (Mycobacterium other than tuberculosis). Laboratory, pathomorphologic, genetic and microbiologic tests of samples obtained from the patient, fish and water in the aquarium gave ambiguous results. A multidisciplinary discussion is presented on the difficulties in the differential diagnosis, problems with a clear interpretation of the results of various conducted tests, and possible ways of transmission of the infection, relevant to the described example.
authors.affiliation: Department and Clinic of Pulmonology, Oncology and Allergology, Medical University of Lublin, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Szmygin-Milanowska
authors.affiliation: Department and Clinic of Pulmonology, Oncology and Allergology, Medical University of Lublin, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Grzywa-Celińska
authors.affiliation: Department of Microbiology, National Reference Mycobacterium Laboratory, Institute for Tuberculosis and Pulmonary Disease in Warsaw, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Zwolska
authors.affiliation: Department and Clinic of Pulmonology, Oncology and Allergology, Medical University of Lublin, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Krawczyk
authors.affiliation: Department of Ichthyologic Diseases and Biology, Institute for Biologic Foundations of Animal Diseases, Department of Veterinary Medicine, University of Life Sciences in Lublin, Poland.
authors.forename: Leszek
authors.initials: L
authors.lastname: Guz
authors.affiliation: Department and Clinic of Pulmonology, Oncology and Allergology, Medical University of Lublin, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Milanowski
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009164:Mycobacterium Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D011044:Poland; D014382:Tuberculosis, Cutaneous / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D014871:Water Microbiology