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Cutaneous miliary tuberculosis in a chronic kidney disease patient.

Suraprasit P, Silpa-Archa N, Triwongwaranat D - Case Rep Dermatol (2014)

Bottom Line: Pulmonary and cutaneous miliary tuberculosis was diagnosed.The patient's symptoms improved after 3 weeks of treatment with isoniazid, rifampicin, ethambutol and pyrazinamide.This report details a case of cutaneous miliary tuberculosis in a non-dialysis chronic kidney disease patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

ABSTRACT
A 79-year-old Thai woman with advanced renal failure, dyslipidemia and anemia of chronic disease was admitted to hospital with prolonged fever, productive cough and multiple discrete small pustules on her face, trunk and extremities. A chest X-ray revealed diffuse miliary infiltration. Mycobacterium tuberculosis complex DNA was detected by polymerase chain reaction in sputum and scrapings of pustules from her skin. Blood culture identified M. tuberculosis complex. Pulmonary and cutaneous miliary tuberculosis was diagnosed. The patient's symptoms improved after 3 weeks of treatment with isoniazid, rifampicin, ethambutol and pyrazinamide. This report details a case of cutaneous miliary tuberculosis in a non-dialysis chronic kidney disease patient.

No MeSH data available.


Related in: MedlinePlus

Multiple discrete small pustules distributed on the face (a), trunk (b) and extremities (c, d).
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Figure 1: Multiple discrete small pustules distributed on the face (a), trunk (b) and extremities (c, d).

Mentions: A 79-year-old Thai woman with a history of CKD stage 5 (serum creatinine level 4.5–5.0 mg/dl), dyslipidemia and anemia of chronic disease presented with fatigue, low-grade fever and a productive cough for the last 2 months. She denied any history of tuberculosis infection. Her current medication was manidipine hydrochloride (10 mg/day) and furosemide (20 mg/day). Physical examination revealed fever, fine crepitation in both lungs and multiple discrete small pustules on her face, trunk and extremities (fig. 1). Laboratory findings showed a hemoglobin level of 9.2 g/dl, a white cell count of 21,060/mm3 with 91.2% neutrophils, and a platelet count of 210,000/mm3. An anti-HIV test was negative. Radiography of the chest revealed diffuse reticulonodular infiltration of both lungs. Sputum examination was positive for acid-fast bacilli and Mycobacterium tuberculosis complex DNA was detected by polymerase chain reaction. Skin scrapings from pustules of the right thigh were positive for acid-fast bacilli and M. tuberculosis complex DNA was detected by polymerase chain reaction. She was diagnosed with pulmonary and cutaneous miliary tuberculosis. Blood cultures identified M. tuberculosis complex 50 days later. She was started on an initial therapy of isoniazid (300 mg/day), rifampicin (450 mg/day), ethambutol (800 mg/day) and pyrazinamide (1,500 mg/day). The pustules subsided after 3 weeks of treatment and pulmonary symptoms improved after 5 weeks of treatment.


Cutaneous miliary tuberculosis in a chronic kidney disease patient.

Suraprasit P, Silpa-Archa N, Triwongwaranat D - Case Rep Dermatol (2014)

Multiple discrete small pustules distributed on the face (a), trunk (b) and extremities (c, d).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4255995&req=5

Figure 1: Multiple discrete small pustules distributed on the face (a), trunk (b) and extremities (c, d).
Mentions: A 79-year-old Thai woman with a history of CKD stage 5 (serum creatinine level 4.5–5.0 mg/dl), dyslipidemia and anemia of chronic disease presented with fatigue, low-grade fever and a productive cough for the last 2 months. She denied any history of tuberculosis infection. Her current medication was manidipine hydrochloride (10 mg/day) and furosemide (20 mg/day). Physical examination revealed fever, fine crepitation in both lungs and multiple discrete small pustules on her face, trunk and extremities (fig. 1). Laboratory findings showed a hemoglobin level of 9.2 g/dl, a white cell count of 21,060/mm3 with 91.2% neutrophils, and a platelet count of 210,000/mm3. An anti-HIV test was negative. Radiography of the chest revealed diffuse reticulonodular infiltration of both lungs. Sputum examination was positive for acid-fast bacilli and Mycobacterium tuberculosis complex DNA was detected by polymerase chain reaction. Skin scrapings from pustules of the right thigh were positive for acid-fast bacilli and M. tuberculosis complex DNA was detected by polymerase chain reaction. She was diagnosed with pulmonary and cutaneous miliary tuberculosis. Blood cultures identified M. tuberculosis complex 50 days later. She was started on an initial therapy of isoniazid (300 mg/day), rifampicin (450 mg/day), ethambutol (800 mg/day) and pyrazinamide (1,500 mg/day). The pustules subsided after 3 weeks of treatment and pulmonary symptoms improved after 5 weeks of treatment.

Bottom Line: Pulmonary and cutaneous miliary tuberculosis was diagnosed.The patient's symptoms improved after 3 weeks of treatment with isoniazid, rifampicin, ethambutol and pyrazinamide.This report details a case of cutaneous miliary tuberculosis in a non-dialysis chronic kidney disease patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

ABSTRACT
A 79-year-old Thai woman with advanced renal failure, dyslipidemia and anemia of chronic disease was admitted to hospital with prolonged fever, productive cough and multiple discrete small pustules on her face, trunk and extremities. A chest X-ray revealed diffuse miliary infiltration. Mycobacterium tuberculosis complex DNA was detected by polymerase chain reaction in sputum and scrapings of pustules from her skin. Blood culture identified M. tuberculosis complex. Pulmonary and cutaneous miliary tuberculosis was diagnosed. The patient's symptoms improved after 3 weeks of treatment with isoniazid, rifampicin, ethambutol and pyrazinamide. This report details a case of cutaneous miliary tuberculosis in a non-dialysis chronic kidney disease patient.

No MeSH data available.


Related in: MedlinePlus