When a respiratory pathogen turns to the skin: cutaneous tuberculosis in a lung transplant patient

A 62-year-old male, who received immune suppressive therapy due to a lung transplantation several years ago, developed multiple painful abscesses in the right forearm. First misdiagnosed as staphylococcal abscesses, Mycobacterium tuberculosis was eventually cultured from the abscesses. In addition, the patient also suffered from pulmonary tuberculosis and respiratory specimens were also culture-positive for Mycobacterium tuberculosis. Cutaneous tuberculosis must be kept as a differential diagnosis in the case of abscess-like lesions on the skin, especially in immunocompromised patients. Mycobacteria specific tests (polymerase chain reaction in respiratory samples and wound smears) and antituberculotic combination therapy are necessary to treat Mycobacterium tuberculosis infection/reactivation adequately.