E-ISSN 2146-9369 | ISSN 2146-3158
 

Case Report


Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report

Gashaw Solela, Alazar Sitotaw.

Abstract
Background:
Cutaneous lesions account for less than 2% of all extrapulmonary manifestations of tuberculosis (TB). Metastatic tuberculous abscesses (tuberculous gummas), uncommon forms of cutaneous TB, typically result from the bacillus spreading hematogenously from the main site of infection to the subcutaneous tissue when the body's cell mediated immunity is compromised and present with one or more non-tender and fluctuant subcutaneous nodules.
Case Presentation:
A 51-year-old male presented with dry cough of one month duration associated with loss of appetite, easy fatigability and vomiting of ingested matter. He had left armpit and lower back skin swellings of similar duration. Physical findings were remarkable for whitish coat over the dorsal part of the tongue, crepitation over the lower two-third of bilateral posterior chest, and non-tender fluctuant masses over the left axilla and lower back region. Chest X-ray revealed multiple bilateral air space nodules and abdominopelvic U/S showed numerous hypoechoic splenic lesions. Urine lipoarabinomannan and Xpert MTB/RIF (mycobacterium tuberculosis/rifampicin) assay from the axillary skin abscess were positive for MTB. He was started on anti-tuberculous therapy and showed marked improvement after a month of follow up.
Conclusion:
It is worth considering the uncommon manifestations of tuberculosis including metastatic skin abscesses in the appropriate clinical context, to avoid misdiagnosis and underreporting in high tuberculosis burden countries. We strongly advise the utilization of Xpert MTB/RIF assay and/or urine lipoarabinomannan for the diagnosis of different forms of tuberculosis including cutaneous TB in HIV positive patients, especially in the absence of sputum for microbiologic tests, like in our patient

Key words: Disseminated tuberculosis, Cutaneous tuberculosis, Metastatic skin abscesses, Immunocompromised patient


 
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Pubmed Style

Solela G, Sitotaw A. Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report. J Microbiol Infect Dis. 2023; 13(3): 168-170. doi:10.5455/JMID.2023.v13.i3.10


Web Style

Solela G, Sitotaw A. Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report. https://www.jmidonline.org/?mno=158287 [Access: February 02, 2024]. doi:10.5455/JMID.2023.v13.i3.10


AMA (American Medical Association) Style

Solela G, Sitotaw A. Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report. J Microbiol Infect Dis. 2023; 13(3): 168-170. doi:10.5455/JMID.2023.v13.i3.10



Vancouver/ICMJE Style

Solela G, Sitotaw A. Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report. J Microbiol Infect Dis. (2023), [cited February 02, 2024]; 13(3): 168-170. doi:10.5455/JMID.2023.v13.i3.10



Harvard Style

Solela, G. & Sitotaw, . A. (2023) Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report. J Microbiol Infect Dis, 13 (3), 168-170. doi:10.5455/JMID.2023.v13.i3.10



Turabian Style

Solela, Gashaw, and Alazar Sitotaw. 2023. Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report. Journal of Microbiology and Infectious Diseases, 13 (3), 168-170. doi:10.5455/JMID.2023.v13.i3.10



Chicago Style

Solela, Gashaw, and Alazar Sitotaw. "Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report." Journal of Microbiology and Infectious Diseases 13 (2023), 168-170. doi:10.5455/JMID.2023.v13.i3.10



MLA (The Modern Language Association) Style

Solela, Gashaw, and Alazar Sitotaw. "Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report." Journal of Microbiology and Infectious Diseases 13.3 (2023), 168-170. Print. doi:10.5455/JMID.2023.v13.i3.10



APA (American Psychological Association) Style

Solela, G. & Sitotaw, . A. (2023) Uncommon manifestation of disseminated tuberculosis with metastatic skin abscesses in an immunocompromised adult patient: A case report. Journal of Microbiology and Infectious Diseases, 13 (3), 168-170. doi:10.5455/JMID.2023.v13.i3.10