Miliary tuberculosis presenting as skin lesions in a patient with acquired immunodeficiency syndrome

Acute miliary tuberculosis of the skin is an extremely rare infection that occurs in immunocompromised persons. We report an intravenous drug abuser with human immunodeficiency virus infection in whom erythematous papules developed on the trunk and proximal aspect of the extremities. Visceral lesions of unsuspected miliary tuberculosis were discovered at autopsy, and the cutaneous papules were found to contain Mycobacterium tuberculosis. This is the first reported case of this cutaneous infection in a patient with the acquired immunodeficiency syndrome.