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Year : 2015  |  Volume : 33  |  Issue : 1  |  Page : 192--193

Cutaneous TB-presenting as recurrent non-healing sinuses

BK Madhusudhan1, B Madhusudhan2,  
1 Professor in Microbiology, Shree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
2 Consultant Surgeon, B.R.Santhanakrishnan Hospital Pvt Ltd, Chennai, Tamil Nadu, India

Correspondence Address:
B K Madhusudhan
Professor in Microbiology, Shree Balaji Medical College and Hospital, Chennai, Tamil Nadu
India

How to cite this article:
Madhusudhan B K, Madhusudhan B. Cutaneous TB-presenting as recurrent non-healing sinuses.Indian J Med Microbiol 2015;33:192-193

How to cite this URL:
Madhusudhan B K, Madhusudhan B. Cutaneous TB-presenting as recurrent non-healing sinuses. Indian J Med Microbiol [serial online] 2015 [cited 2019 Dec 8 ];33:192-193
Available from: http://www.ijmm.org/text.asp?2015/33/1/192/148445

Full Text

Dear Editor,

Tuberculosis is a global health problem. Incidence of extrapulmonary tuberculosis has been showing an increasing trend in recent years. Diagnosis is based on a high index of suspicion, correlating with laboratory, radiological and clinical findings.

Two months back a case was reported of a 45-year-old male, with history of a chronic sinus over lower 1/3 of medial aspect of right thigh following incision and drainage. Discharge from the sinus area was negative for Gram's, acid-fast Bacilli and fungal staining. Culture and sensitivity showed no growth. MRI revealed no bony involvement. Patient had no associated constitutional symptoms like fever, weight loss, or lymphadenopathy. Haematological, biochemical parameters and X-ray chest were normal. Excision biopsy was done and was reported as, non-specific granulomatous reaction. Patient developed multiple sinuses along the suture line, within 1 month of surgery. Biopsy was repeated and the tissue sent for HPE revealed presence of tuberculous granulation tissue. Repeat smears for AFB showed, occasional TB bacilli. Patient showed drastic improvement within 4 weeks of starting anti-tuberculous therapy (4 drug regimen).

In endemic areas and in suspected cases of tuberculosis, repeated smear study, FNAC or biopsy, along with newer diagnostic techniques like ELISA, BACTEC, DNA probes or PCR should be done to establish an early diagnosis, as most cutaneous tubercular lesions are paucibacillary. [1],[2],[3]

References

1Fariña MC, Gegundez MI, Piqué E, Esteban J, Martín L, Requena L, et al. Cutaneous tuberculosis: A clinical histopathologic, and bacteriologic study. J Am Acad Dermatol 1995;33:433-40.
2Hsiao PF, Tzen CY, Chen HC, Su HY. Polymerase chain reaction based detection of mycobacterium tuberculosis in tissues showing granulomatous inflammation without demonstrable acid-fast bacilli. Int J Dermatol 2003;42:281-6.
3Negi SS, Basir SF, Gupta S, Pasha ST, Khare S, Lal S. Comparative study of PCR, smear examination and culture for diagnosis of cutaneous tuberculosis. J Commun Dis 2005;37:83-92.