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Cutaneous extensively drug-resistant tuberculosis.

Douglas P Olson1, Cheryl L Day, Nombulelo P Magula

  • 1Department of Infectious Disease, Division of Medicine, and HIV Pathogenesis Programme, University of KwaZulu Natal, Durban, South Africa. douglas.olson@yale.edu

The American Journal of Tropical Medicine and Hygiene
|September 11, 2007
PubMed
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This study reports the first case of extensively drug-resistant cutaneous tuberculosis in an immunocompetent patient. The diagnosis was confirmed through biopsy, revealing resistance to multiple tuberculosis treatments.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Microbiology

Background:

  • Cutaneous tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection.
  • Immunocompetent individuals typically present with localized disease, but extensive forms can occur.

Observation:

  • A 48-year-old immunocompetent man presented with a decade-long history of recurrent skin lesions.
  • No prior or concurrent pulmonary tuberculosis was identified.

Findings:

  • Biopsy cultures confirmed extensively drug-resistant tuberculosis (XDR-TB) affecting the skin.
  • The patient exhibited a robust CD4+ T-cell immune response to various tuberculosis antigens.

Implications:

  • This case highlights the potential for XDR-TB to manifest solely in the skin, even in immunocompetent hosts.

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  • It underscores the need for comprehensive diagnostic workups and susceptibility testing for challenging cutaneous infections.
  • Further research into the pathogenesis and treatment of XDR cutaneous tuberculosis is warranted.