Cases reported "Tuberculosis, Cutaneous"

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1/12. Cutaneous malakoplakia: a report of two cases with the use of anti-BCG for the detection for micro-organisms.

    Malakoplakia is an uncommon granulomatous infectious disease that is found primarily in the genito-urinary tract, but may rarely involve the skin. Histologic findings are marked by the presence of foamy macrophages containing basophilic concentric spherules, the Michaelis-Gutman bodies. Micro-organisms are not readily identifiable. Immunostaining with polyclonal anti-mycobacterium bovis (BCG) has been described as a method of identifying bacterial and fungal organisms in situations where organisms may be sparse. We report 2 cases of cutaneous malakoplakia with demonstration of organisms by immunostaining with anti-BCG antibodies.
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ranking = 1
keywords = mycobacterium bovis, mycobacterium, bovis
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2/12. Primary tuberculous chancre caused by mycobacterium bovis after goring with a bull's horn.

    A 14-year-old boy was gored by a bull during festival celebrations. The horn of the bull caused a wound on his left hand and after 3 months it was a accompanied by an ulcerated nodule on the left upper arm and an axillary adenopathy. The tuberculin test was positive and a culture of the aspiration biopsy specimen of the axillary lymph node yielded Mycombacterium bovis.
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ranking = 0.044337163468894
keywords = bovis
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3/12. Lichen scrofulosorum.

    A 12-month-old boy with pulmonary tuberculosis developed a papular lichenoid eruption which showed epithelioid granulomas on histology, consistent with lichen scrofulosorum. Stains and cultures for mycobacteria in the skin were negative, and a polymerase chain reaction (PCR) analysis failed to detect the dna of mycobacterium tuberculosis in a skin biopsy specimen, thus making lichen scrofulosorum one of the remaining manifestations of M. tuberculosis infection in which evidence of the bacillus has not been found to date. Lichen scrofulosorum is now considered a rare form of tuberculid but should not be neglected.
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ranking = 0.10844740709072
keywords = bacillus
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4/12. Tuberculosis verrucosa cutis associated with tuberculous lymphadenitis.

    A 34-year-old man presented with a large cutaneous lesion on his left thigh that had started as a small papule when he was 13 years of age. The lesion had enlarged slowly over the last 21 years. The patient had received bacillus Calmette-Guerin (BCG) vaccination in childhood. The family history was significant for tuberculosis. Clinical examination revealed a large, purplish-red, indurated plaque measuring 30 x 29 cm on the left thigh, extending to the buttock area. The edges of the lesion had a serpiginous contour with an involuted center (Fig. 1). A left inguinal lymph node was palpated. Chest X-ray and blood cell count were normal. No other focus of disease was identified. Laboratory testing for human immunodeficiency virus (hiv) infection was negative. Purified protein derivative (PPD) intradermal injection disclosed a 19-mm skin induration. Both the cutaneous lesion and the inguinal lymph node were biopsied. Histopathologic sections of the skin fragment showed epidermal hyperkeratosis, neovascular proliferation, and a dense dermal lymphocytic infiltrate. The histopathology of the lymph node demonstrated few granulomas with focal areas of central necrosis. Staining for fungus was negative. Ziehl-Neelsen staining was negative on both the skin and lymph node specimens. culture for fungus and Leishmania sp. was negative. Tissue culture on Lowenstein-Jensen medium from skin and lymph node was positive for Mycobacterium colonies after 5 and 7 weeks, respectively. Multidrug therapy was instituted with rifampin 600 mg/day, isoniazid 400 mg/day, and pyrazinamide 2 g/day for 2 months, and then rifampin 600 mg/day and isoniazid 400 mg/day alone for the next 4 months. An excellent response was obtained at the end of treatment (Fig. 2).
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ranking = 0.10844740709072
keywords = bacillus
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5/12. Cutaneous complications of BCG vaccination in infants with immune disorders: two cases and a review of the literature.

    Two infants, one with a T-cell-signaling defect resulting in a primary immunodeficiency syndrome and the other with severe combined immunodeficiency (SCID), are described. Both infants developed cutaneous infections secondary to their bacillus Calmette-Guerin (BCG) vaccinations. Both patients were from countries where BCG is routinely administered in infancy. The infant with the T-cell-signaling defect developed a disseminated infection involving the skin, while the infant with SCID developed a localized cutaneous infection at the site of his BCG immunization. These two cases resemble other reported cases of cutaneous BCG infection following routine vaccination in immunocompromised patients. mycobacterium bovis infection should be considered in patients with cutaneous eruptions who have received BCG vaccination, especially those who are immunocompromised.
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ranking = 0.1173148397845
keywords = bacillus, bovis
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6/12. Multiplex PCR-identified cutaneous tuberculosis evoked by mycobacterium bovis BCG vaccination in a healthy baby.

    This is the first identified case of mycobacterium bovis bacillus Calmette-Guerin (BCG)-derived cutaneous tuberculosis that localizes at a place different from the vaccination site in hosts without immune deficiency. A healthy baby with a developing abscess is described. A multiplex PCR identified the abscess as originating from M. bovis BCG tokyo 172.
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ranking = 0.16165200325339
keywords = bacillus, bovis
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7/12. Papulonecrotic tuberculid secondary to mycobacterium bovis.

    A patient with papulonecrotic tuberculid had a pruritic papular eruption associated with constitutional symptoms. The eruption flared whenever the patient received low doses of prednisone to control symptoms of temporal arteritis. A cervical lymph node biopsy specimen demonstrated acid-fast bacilli, and mycobacterium bovis grew on the cultures. The eruption cleared completely with antituberculous therapy. This case demonstrated the clinicopathologic findings compatible with a diagnosis of papulonecrotic tuberculid. Skepticism regarding the existence of papulonecrotic tuberculid is probably a result of the current decreased prevalence of untreated tuberculosis, and the subsequently increased rarity of this entity.
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ranking = 0.044337163468894
keywords = bovis
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8/12. Disseminated atypical mycobacterial infection in hairy cell leukemia.

    The clinical features are described of disseminated atypical mycobacterial infection of the subcutaneous tissues occurring in a patient 3 yr after the diagnosis of hairy cell leukemia. skin biopsy identified the causative organism as an atypical mycobacterium of the M. avium-intracellulare-scrofulaceum (MAIS) complex. in vitro studies showed that the patient had impaired mononuclear cell phagocytosis. These findings, lend support to the hypothesis of a specific defect of immunity in hairy cell leukemia.
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ranking = 0.43707596747651
keywords = mycobacterium
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9/12. Cutaneous spindle-cell pseudotumors due to Mycobacterium gordonae and Leishmania infantum. An immunophenotypic study.

    We report two patients with AIDS who had cutaneous spindle-cell pseudotumors caused by leishmania infantum in one instance and by an atypical mycobacterium in the other. The lesions mimicked neoplasms with predominantly spindled macrophages, similar to those seen in the histoid variant of leprosy. This histoid reaction is known to be related to mycobacteria. To our knowledge, this is the first case of histoid reaction due to leishmania. In both cases, the histiocytic cells were positive for vimentin and desmin but negative for alpha-smooth muscle. In addition, the immunostaining by lysosyme and alpha 1 antitrypsin was positive in both and in one the S-100 protein was positive. This reaction suggests dual myofibroblast and histiocytic differentiation.
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ranking = 0.43707596747651
keywords = mycobacterium
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10/12. Concurrent cytomegalovirus, M. tuberculosis and M. avium-intracellulare cutaneous infection in an hiv patient.

    We report a 25-year-old hiv-positive man with a past medical history of disseminated cytomegalovirus (CMV) infection, who developed cutaneous lesions during a disseminated mycobacterium infection. The histological changes of CMV and acid-fast bacilli were seen on histopathology of the lesions. Cultures were positive for M. tuberculosis and M. avium-intracellulare (MAI). CMV is frequently isolated from hiv patients, but skin involvement is rare. The association of CMV and mycobacteria can occur in cutaneous lesions of AIDS patients, but concurrent cutaneous involvement of CMV, M. tuberculosis, and MAI is unusual. These findings emphasize the polymorphous presentation of infectious disorders in AIDS patients and the need for multiple biopsies and for special stains in such patients.
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ranking = 0.43707596747651
keywords = mycobacterium
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