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Demonstration of Cutaneous Allodynia in Association with Chronic Pelvic Pain
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A pain in the rear.

A Deh1, B A Diatta1, S Diadie1

  • 1Hôpital Aristide Le Dantec, Dakar, Sénégal.

Medecine Et Sante Tropicales
|February 12, 2020
PubMed
Summary

Cutaneous tuberculosis, though rare, presents with varied symptoms and can indicate active pulmonary disease. Early diagnosis and treatment of this buttock gumma in Senegal led to a full recovery.

Keywords:
Senegalbuttocktuberculous gumma

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Pulmonology

Background:

  • Tuberculosis is endemic in Senegal, with rare cutaneous forms accounting for 2% of extrapulmonary cases.
  • Cutaneous tuberculosis exhibits significant clinical polymorphism, making diagnosis challenging.
  • Perineal abscesses warrant investigation for underlying cutaneous tuberculosis.

Purpose of the Study:

  • To report a case of tuberculous gumma of the buttock in an immunocompetent adult.
  • To highlight the diagnostic challenges and clinical presentation of cutaneous tuberculosis.
  • To emphasize the importance of early management for improved prognosis.

Main Methods:

  • Case report of a 47-year-old male with a four-year history of a buttock swelling.
  • Physical examination revealing an indurated, multinodular, polyfistulized plaque with pus emission and lymphadenopathy.
  • Histological examination confirming TB granuloma and gastric fluid analysis positive for acid-fast bacilli.

Main Results:

  • Diagnosis of cutaneous tuberculosis confirmed by histology and positive acid-fast bacilli in gastric fluid.
  • Thoracoabdominopelvic CT revealed bilateral pulmonary micronodules, indicating active pulmonary tuberculosis.
  • Complete resolution of all tuberculosis signs after six months of treatment.

Conclusions:

  • Cutaneous tuberculosis in endemic areas is clinically diverse and requires a high index of suspicion.
  • Cutaneous tuberculosis should be considered in cases of perineal abscesses.
  • Prompt diagnosis and management of cutaneous tuberculosis significantly improve patient outcomes.