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Isolated skin ulcers due to Mycobacterium tuberculosis in a renal allograft recipient.

Ram R, Uppin S, Swarnalatha G, Desai M, Harke M, Prasad N, Dakshinamurty KV

Department of Nephrology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India.

BACKGROUND: A 27-year-old male renal allograft recipient presented to hospital with isolated skin ulcers on both lower limbs. At presentation, he also had a low-grade continuous fever, malaise and anorexia. INVESTIGATIONS: Physical examination, laboratory studies, histopathological examination of tissue biopsy samples from the ulcer edges and ulcer floor, culture of the biopsy tissue, chest radiograph, bone marrow biopsy, abdominal ultrasound, tuberculin skin test and examination of three early morning samples of gastric juice and urine for acid-fast bacilli. DIAGNOSIS: Isolated cutaneous ulcers caused by Mycobacterium tuberculosis. MANAGEMENT: Four-drug antituberculosis therapy with pyrazinamide, of loxacin, ethambutol and isoniazid.

Published 22 November 2007 in Nat Clin Pract Nephrol, 3(12): 688-93.
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