Gao LJ, Huang ZH, Jin QY, Zhang GY, Gao MX, Qian JY, Zhu SX, Yu Y. Delayed diagnosis and comprehensive treatment of cutaneous tuberculosis: A case report. World J Clin Cases 2021; 9(16): 4007-4015 [PMID: 34141760 DOI: 10.12998/wjcc.v9.i16.4007]
Corresponding Author of This Article
Zi-Hui Huang, MBBS, Chief Doctor, Department of Extrapulmonary Tuberculosis, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, No. 179 Xiaolingwei, Xuanwu District, Nanjing 210014, Jiangsu Province, China. huangzihui73@163.com
Research Domain of This Article
Dermatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Lu-Jue Gao, Zi-Hui Huang, Quan-Yong Jin, Min-Xing Gao, Jia-Yan Qian, Si-Xun Zhu, Yang Yu, Department of Extrapulmonary Tuberculosis, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing 210014, Jiangsu Province, China
Guo-Ying Zhang, Department of Laboratory, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing 210014, Jiangsu Province, China
Author contributions: Gao LJ and Huang ZH conceptualized the study and contributed equally to the manuscript; Jin QY, Gao MX, Zhang GY, and Qian JY performed the investigations; Jin QY and Gao MX provided the resources; Zhu SX and Yu Y provided software-based analysis; Huang ZH supervised the study; Gao LJ and Huang ZH wrote the original draft and revised the subsequent drafts through the final version.
Supported byThe Key Science and Technology Project of Nanjing Health and Family Planning Commission, No. ZKX18042; The Youth Talent Project of Nanjing Health and Fitness Commission, No. QRX17030; and The Key Science and Technology Project of National Health Commission, No. ZKX18048.
Informed consent statement: Written informed consent was obtained from the individual for the publication of any potentially identifiable images or data included in this article.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi-Hui Huang, MBBS, Chief Doctor, Department of Extrapulmonary Tuberculosis, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, No. 179 Xiaolingwei, Xuanwu District, Nanjing 210014, Jiangsu Province, China. huangzihui73@163.com
Received: January 25, 2021 Peer-review started: January 25, 2021 First decision: February 25, 2021 Revised: March 7, 2021 Accepted: March 23, 2021 Article in press: March 23, 2021 Published online: June 6, 2021 Processing time: 109 Days and 0 Hours
Abstract
BACKGROUND
Tuberculosis (TB) is a widespread infectious disease, with an incidence that is increasing worldwide. Cutaneous TB (CTB) occurs rarely, accounting for less than 1% of all TB cases. Due to the clinical presentation and diagnostic difficulties, CTB is often clinically neglected and misdiagnosed.
CASE SUMMARY
A 32-year-old man underwent several debridement surgeries and skin flap transplantation after trauma. The wound remained unhealed, accompanied by sinus formation. According to empirical judgment, T-cell spot of TB test, and bacterial culture of pyogenic fluids, he was diagnosed with CTB due to infection with exogenous Mycobacterium tuberculosis. A comprehensive anti-TB regimen that included isoniazid, rifampicin, ethambutol, and pyrazinamide was applied. The sinus was filled with a hydrophilic fiber-containing silver dressing, and wound-protecting sponges were applied to part of the wound. The wound healed after 40 d. No ulceration was found within 2 mo after discharge; further follow-up will be conducted.
CONCLUSION
A non-healing wound may be caused by TB infection. Comprehensive treatment of CTB is effective.
Core Tip: Cutaneous tuberculosis (TB) is rare, and thus likely to be neglected and misdiagnosed. We report the case of a middle-aged man who suffered from repeated wound ulceration within 1 year after trauma. He was subsequently diagnosed with cutaneous TB (CTB) due to infection with exogenous Mycobacterium tuberculosis, which was confirmed by empirical judgment and a series of examinations. The patient received combination treatment with dressing change. The wound healed after 40 d. This case highlights the possibility of CTB infection in wounds that do not heal over a long period, and the importance of timely diagnosis and comprehensive treatment of this disease.
