International Journal of Gerontology
Volume 2, Issue 2 , Pages 79-82, June 2008

Cutaneous Tuberculosis Presenting as Necrotizing Fasciitis in an Elderly Patient

  • Wen-Chin Cho

      Affiliations

    • Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taipei, Taiwan
    • ,
  • Yung-Chia Pai

      Affiliations

    • Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taipei, Taiwan
    • Mackay Medicine, Nursing and Management College, Taipei, Taiwan
    • ,
  • Yung Hsiung

      Affiliations

    • Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taipei, Taiwan
    • ,
  • Wai-Mau Choi

      Affiliations

    • Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Wai-Mau Choi, Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, 690, Section 2, Guangfu Road, Hsinchu, Taiwan

Accepted 10 March 2008.

Article Outline

Summary 

We report a case of cutaneous tuberculosis presenting as cellulitis and necrotizing fasciitis of the bilateral lower legs. The patient was a 79-year-old male who denied any history of chronic medical diseases such as hypertension, diabetes or old cerebrovascular accident. He had developed itchy skin papules since August 2008. His clinical cellulitis failed to respond to antibiotic therapy. Subsequent investigations involving both acid-fast bacilli cultures and smears of neck lymph nodes were positive, and established the alternative diagnoses of cutaneous tuberculosis, hyper-IgE syndrome and eosinophilia. The skin eruption cleared after treatment with isoniazid, rifampicin and pyrazinamide. This case represents a most unusual presentation of tuberculosis in the skin. The atypical features may reflect the patient's general medical state.

Key Words:  cellulitis , cutaneous tuberculosis , eosinophilia , hyper-IgE syndrome , necrotizing fasciitis

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PII: S1873-9598(08)70016-4

doi:10.1016/S1873-9598(08)70016-4

International Journal of Gerontology
Volume 2, Issue 2 , Pages 79-82, June 2008

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