ABSTRACT
La TBC es una enfermedad causada por Mycobacterium tuberculosis y afecta usualmente el pulmón aunque un pequeño porcentaje se puede presentar en la forma cutánea. Se presenta el caso de un varón de 23 años, natural de la provincia de Madre de Dios, que desarrolló TBC pulmonar y cutánea causado por Mycobacterium tuberculosis MDR. El diagnóstico se hizo por Bk de secreción cutánea y Bk de esputo con resultado positivo en ambos casos; presentó además edema en hemicuerpo izquierdo, y ulceras a nivel esternal y a nivel clavicular. El paciente fue hospitalizado como enfermedad TBC pulmonar y extrapulmonar. El caso reportado pone en énfasis la TBC cutánea y el riesgo que esto significa aun en pacientes inmunocompetentes.
TBC caused by Mycobacterium tuberculosis and affects usually the lung, although a small percentage of patients present with skin involvement. We present the case of a 23-year-old male patient from Madre de Dios who developed both pulmonary and skin TBC caused by multi-drug resistant Mycobacterium tuberculosis. The diagnosis was made by detecting Mycobacterium using acid fast stains in sputum and skin samples. This case illustrates the risk that immunosuppressed patients has to get cutaneous tuberculosis.
Subject(s)
Male , Humans , Young Adult , Tuberculosis, Cutaneous , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , Tuberculosis, Multidrug-ResistantABSTRACT
La Tuberculosis Cutánea es una enfermedad infecciosa crónica causada por el Mycobacterium tuberculosis. Pese a ser una forma poco frecuente de presentación de la Tuberculosis, representa un gran desafío para los clínicos que se enfrentan a estos casos, debido principalmente a la gran diversidad de formas clínicas existentes. A continuación presentamos 2 casos clínicos de Tuberculosis Cutánea diagnosticados en el Hospital Regional de Talca y una revisión del tema basada en la clasificación, diagnóstico y tratamiento de la enfermedad.
Cutaneous Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. Despite being a rare presentation of the disease, Cutaneous Tuberculosis is a major challenge for clinicians who face these cases, mainly due to the great diversity of clinical forms. We present 2 cases of Cutaneous Tuberculosis diagnosed in Hospital Regional de Talca and a review of the topic based in classification, diagnosis and treatment of the disease.
Subject(s)
Humans , Male , Female , Middle Aged , Tuberculosis, Cutaneous/classification , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , Erythema Induratum/classification , Erythema Induratum/diagnosis , Erythema Induratum/therapyABSTRACT
La tuberculosis cutánea es una enfermedad infecciosa crónica causada por el Mycobacterium tuberculosis. Se presenta en una variedad de formas clínicas que dependen de la vía de llegada del bacilo a la piel y del estado inmunológico del paciente. La reacción en cadena de la polimerasa (RCP) ha permitido enrolar en el grupo de la tuberculosis cutánea a entidades antes reconocidas como tuberculides. Sin embargo, en muchos casos, la RCP no está disponible en países en desarrollo, en los cuales la incidencia considerable presenta a la tuberculosis como un problema de salud pública. Se presenta cuatro pacientes con formas clínicas distintas de tuberculosis cutánea (tuberculide papulonecrótica, escrofuloderma, tuberculosis verrucosa cutis y eritema indurado de Bazin), que reciben tratamiento antituberculoso de acuerdo al esquema nacional de tratamiento con evolución favorable.
Cutaneous tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. lt comes in a variety of clinical forms depending on the route of arrival of the bacillus to the skin and the immune status of the patient. The polymerase chain reaction (PCR) has allowed enrolling in group TB skin entities before recognized as tuberculids; however often not available in developing countries in which the considerable incidence that tuberculosis has, it becomes a problem public health. We report 4 patients with different clinical forms of cutaneous tuberculosis (tuberculid papulonecrotic, scrofuloderma, tuberculosis verrucosa cutis and indurated erythema Bazin) receiving tuberculosis treatment according to national treatment regimen with a favorable evolution.
Subject(s)
Humans , Male , Adult , Young Adult , Middle Aged , Tuberculosis, Cutaneous , Tuberculosis, Cutaneous/classification , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/etiology , Tuberculosis, Cutaneous/therapyABSTRACT
La tuberculosis verrugosa es una enfermedad infecciosa crónica producida por Mycobacterium tuberculosis. Actualmente se ve un incremento de la tuberculosis por la resistencia del bacilo a los fármacos y por el virus de la inmunodeficiencia adquirida. Presenta una gran variedad clínica y es un reto diagnóstico. Se presenta un caso con buena evolución con el tratamiento antituberculoso.
The warty tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis. Is now increased by the tuberculosis bacillus resistance to drugs and for the acquired immunodeficiency virus. Presents a clinical variety and is a diagnostic challenge. A case is presented with its good performance with tuberculosis treatment.
Subject(s)
Humans , Male , Adult , Medical Illustration , Mycobacterium tuberculosis , Tuberculosis, Cutaneous , Tuberculosis, Cutaneous/pathology , Tuberculosis, Cutaneous/therapySubject(s)
Humans , Female , Tuberculosis, Cutaneous/therapy , Tuberculosis, Cutaneous/pathology , Abscess , Skin DiseasesABSTRACT
La Tuberculosis cutánea es una enfermedad infecciosa crónica causada por Mycobacterium tuberculosis. Se presenta en una variedad de formas clínicas que dependen de la vía de llegada del bacilo a la piel y del estado inmunológico del huésped; la mayoría procede de fuente endógena. LaTuberculosis es una enfermedad de alta prevalencia en países en vías de desarrollo como el nuestro, siendo las formas cutáneas cerca del 1 % -2 % del total de las tuberculosis. En los últimos tiempos se ha visto un resurgimiento de la tuberculosis cutánea que se corresponde con el aumento en la incidencia de la tuberculosis en todo el mundo. Se reporta el caso de un paciente varón de 22 años con una tumoración fluctuante en la axila derecha que correspondió a una tuberculosis colicuativa o escrofuloderma y evolucionó favorablemente al tratamiento antituberculoso; una primera fase con rifampicina 600 mg/día, isoniacida 300 mg/día, pirazinamida 1.5 g/día y tambutol 1.2g/día, diario excepto domingos y feriados por 2 meses; seguidos de una segunda fase con isoniacida 800mg/d y rifampicina 600mg/d, dos veces por semana por 4 meses, observándose una resolución completa del proceso. Presentamos este caso por ser una entidad de difícil diagnóstico, por su variada presentación clínica y la dificultad de su confirmación diagnóstica.
The colliquative cutaneous tuberculosis is achronic infectious disease caused by Mycobacterium tuberculosis. It appears ina broad clinical spectrum that depends onthe orute of arrival of the bacillus to the skin and on the immunological condition of the guest; the majority come from endogenous. Tuberculosis is a disease og high prevalence in developing countries as ours, being the cutaneous forms near 1 û 2% of the total. Now a days it has seen a revival of the cutaneous tuberculosis corresponding to the increase in the incident of tuberculosis in the world. This is the case of a 22 year-old male patient with a fluctuating tumor in the right axilla that correrponded to a collicuative cutaneous tuberculosis or scrofuloderma and favorably outcome with the antituberculosis treatment. The initial phase with rifampin 600 mg/day and etambutol 1,2 g/ day, except on Sundays and hoilidays during 2 months, followed by the second phase with isoniazid 800 mg/d and rifampicin 600 mg(day twice a week for 4 months. A full clinical recovery was observed. This case is brought due to its difficult diagnose, its clinical spectrum and the difficulty of the diagnose confirmation.
Subject(s)
Humans , Male , Young Adult , Tuberculosis, Cutaneous/classification , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , Case ReportsABSTRACT
Cutaneous granulomatous dermatoses usually are a diagnostic challenge with tuberculosis [TB] on top of them. TB is a universal health problem and considered by WHO at the top of 6 common and dangerous infectious diseases. To determine the clinical, laboratory and histopathological findings in 45 patients with the diagnosis of cutaneous TB over a 10-year period in Ahwaz. This is an existing data study on the records of all patients with the diagnosis of TB admitted to Sina Hospital in Ahwaz from November 1990 to March 1999. Data on the age, localization, clinical features were extracted from hospital records. The age range of patients was between 1-76 years. Twenty-eight cases were females and 17 cases were males. Twenty-three cases were clinically diagnosed as scrofuloderma [SFD], 18 cases as lupus vulgaris [LV], 1 case as erythema induratum, 1 case as TB gumma, 1 case as orificial TB and 1 case as populonecrotic tuberculoid. The most common involved site was the face and the least common sites of involvement were the buttock and elbow. Six cases had positive family history. SFD was present in 12 females and 11 males.The result of tuberculin test was positive in 15, negative in 17 and not available in 13 patients. Histopathologically, 23 cases showed chronic granulomatous disease without caseation, 18 cases showed nonspecific inflammation and in 3 cases tubercle with caseation was observed. Concerning treatment, we found generally good clinical response with no failure in 32 patients who came for follow up. This study showed that in Ahwaz SFD was the most common form of cutaneous TB and the most frequent site of involvement was the face
Subject(s)
Humans , Male , Female , Tuberculosis, Cutaneous/therapy , Erythema Induratum , Tuberculosis, Cutaneous/pathology , Tuberculin TestABSTRACT
Dessensibilização tuberculínica é uma das principais terapias para tuberculides. Alguns relatos de caso da doença referem apenas tratamento com drogas antituberculosas. Embora haja polêmica sobre o assunto, a dessensibilização tuberculínica possui importante papel nas reações de hipersensibilidade aos antígenos do bacilo e deve ser considerada sempre que pacientes tiverem diagnóstico de tuberculides. Este artigo descreve as indicações clínicas da dessensibilização, seu preparo, posologia nas diferentes formas de tuberculides e possíveis efeitos colaterais observados.
Subject(s)
Humans , Male , Female , Desensitization, Immunologic/adverse effects , Desensitization, Immunologic/methods , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , TherapeuticsABSTRACT
Tubercúlides representam uma forma de reação de hipersensibilidade a antígenos bacterianos liberados de um foco de infecção distante. A maioria dos pacientes é caracterizada por apresentar PPD forte reator e evidência de passado de tuberculose pulmonar e(ou) contactante. O tratamento é baseado na terapia de dessensibilização com tuberculina, drogas antituberculosas e corticóides.
Tuberculids represent a form of hypersensitivity reaction to tuberculosis antigens released from a distant focus of infection. Most of patients are characterized by displaying a markedly positive Mantoux skin test and evidence of past tuberculosis infection or contacts of patient with tuberculosis. The treatment is based on tuberculin desensitizing therapy, antituberculous drugs and corticosteroids.
Subject(s)
Humans , Male , Female , Erythema Induratum , Erythema Nodosum , Lichenoid Eruptions/classification , Tuberculosis, Lymph Node , Tuberculosis, Ocular , Tuberculosis, Osteoarticular , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/etiology , Tuberculosis, Cutaneous/immunology , Tuberculosis, Cutaneous/therapy , Antitubercular Agents/administration & dosage , Antitubercular Agents/therapeutic use , Hypersensitivity, Delayed/diagnosis , /immunology , Mycobacterium bovis/pathogenicity , Mycobacterium tuberculosis/pathogenicity , Tuberculin Test , Tuberculin/therapeutic useABSTRACT
La tuberculosis (TBC) Cutánea sigue siendo en frecuencia a la TBC pulmonar, generalmente es una reinfección. Existen numerosas clasificaciones de TBC cutánea, pero la que más se adapta a nuestras condiciones tropicales es la de Gratti. La infección tuberculosa cutánea primaria o chancro tuberculoso resulta de la inoculación de microbacterias en la piel de un huésped no previamente infectado, a través de una solución de continuidad. La frecuencia es bastante baja. El objetivo del presente trabajo es la presentación inusual de una tuberculosis cutánea en un preescolar como complejo primario y posterior diseminación hematógena a meninges, pulmón y ganglio; tratado con cuatro drogas antituberculosas con evolución satisfactoria, sin secuelas
Subject(s)
Humans , Male , Child , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapyABSTRACT
Imformamos un caso de tuberculosis vegetante perianal. Un hombre de 59 años presentaba múltiples vegetaciones fistulizadas alrededor del ano y genitales. El disgnóstico fue confirmado por cultivo. La cirugía y agentes tuberculostáticos fueron efectivos. Presentamos una revisión bibliográfica reciente
Subject(s)
Humans , Male , Middle Aged , Anus Diseases/diagnosis , Anus Diseases/therapy , Tuberculosis , Tuberculosis, Cutaneous/surgery , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapy , Tuberculosis, Male Genital/diagnosis , Tuberculosis, Male Genital/therapy , Cells, Cultured , Isoniazid/therapeutic use , Pyrazinamide/therapeutic use , Rifampin/therapeutic use , Streptomycin/therapeutic useABSTRACT
Se describen cuatro pacientes estudiados en el Servicio de Dermatología del Instituto de Biomedicina entre 1990 y 1991 uno con diagnóstico de lupus vulgar y tres con el de escrofuloderma. Estas formas de presentación reflejan lo descrito en zonas tropicales donde la forma más común es la escrofuloderma, seguido de la tuberculosis verrugosa cutis y en tercer lugar se ubica el lupus vulgar. Se analiza la existencia de un espectro de respuesta inmune frente a la infección tuberculosa, señalando como formas polares al lupus vulgar y a la escrofuloderma y se describen las características que las definen
Subject(s)
Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Cutaneous/therapyABSTRACT
Se efectúa un estudio de la acción del agua del Volcán Copahue (AVC) sobre 14 cepas de micobacterias. Los tres ensayos utilizados para determinar resistencia o sensibilidad al agua dieron resultados coincidentes. Las Micobacterias no tuberculosas presentaron distintos grados de resistencia, en cambio M.tuberculosis, M. bovis y M.marinum mayor sensibilidad. Se complementa con breves estudios de la acción del AVC sobre el efecto pH, destrucción del "factor cuerda" de los bacilos, y pérdida de su actividad enzimática (catalasa y peroxidasa)