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Tuberculous cellulitis: diseases behind cellulitislike erythema
Masayuki Sakiyama1, Hirotaka Maeshima1, Minoru Chishiki1
1Department of Dermatology, Self Defense Forces Central Hospital, Mishuku Hospital, Tokyo, Japan.
Cutis
|August 17, 2016
Summary
Tuberculous cellulitis, a rare presentation of tuberculosis, mimics common skin infections. Early diagnosis is crucial, especially when antibiotic treatment fails, to identify this significant underlying disease.
Area of Science:
- Dermatology
- Infectious Diseases
- Microbiology
Background:
- Cellulitis is a frequent dermatological condition often treated with antibiotics.
- Differential diagnosis of cellulitis is broad and can include uncommon infections.
- Cutaneous tuberculosis presents a diagnostic challenge due to its varied clinical manifestations.
Observation:
- An elderly male presented with an erythematous thigh plaque resembling cellulitis.
- Standard antibiotic treatments were ineffective for the patient's condition.
- Skin biopsy revealed epithelioid granulomas and acid-fast bacilli.
Findings:
- Mycobacterium tuberculosis was identified in skin, gastric, and sputum samples.
- The patient was diagnosed with tuberculous cellulitis and pulmonary tuberculosis.
- Tuberculous cellulitis, unlike other cutaneous tuberculosis forms, can be painful.
Implications:
- Cutaneous tuberculosis must be considered in refractory cellulitis-like rashes.
- Prompt diagnosis of tuberculous cellulitis is essential for effective treatment and public health.
- This case highlights the importance of considering tuberculosis in atypical skin presentations, particularly in endemic areas.
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