Abstract:
INTRODUCTION : Extrapulmonary tuberculosis (TB) causes a significant burden of disease
worldwide, especially among HIV-infected individuals and those with other immunosuppressive
conditions. Cutaneous TB is an important manifestation of extrapulmonary TB but is
uncommonly reported in South Africa despite the high burden of HIV and TB co-infection.
There is a paucity of published data on clinical presentation and outcome of cutaneous TB in
this context. Raising awareness of this condition among clinicians is imperative to improve
early diagnosis and optimise treatment outcomes.
PATIENT PRESENTATION : In this series, we present three cases of cutaneous TB, two adults and one
child, referred to a tertiary hospital from two primary healthcare centres and from a general
practitioner. We demonstrate that the clinical presentation is diverse, ranging from papular
lesions to abscesses, and that concordant pulmonary TB may be present.
MANAGEMENT : In particular, we show the importance of performing diagnostic
procedures (e.g. aspiration) in individuals presenting with an abscess that does not
respond to broad spectrum antimicrobial treatment, particularly in those with advanced
immunosuppression.
OUTCOME AND CONCLUSION : The outcome of our three patients was poor, highlighting the need
for earlier diagnosis in this WHO Stage 4 condition and intensive management of clinical
cases.
