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[Atypical erythema induratum Bazin with tuberculous osteomyelitis]
M Degonda Halter1, P Nebiker, B Hug
1Klinik für Infektiologie und Spitalhygiene, Universitätsspital, 4031, Basel. sbassetti@uhbs.ch
Abstract:
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.
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