Degonda Halter M, Nebiker P, Hug B, Oberholzer M, Flückiger U, Bassetti S
Klinik für Infektiologie und Spitalhygiene, Universitätsspital, 4031, Basel.
Internist (Berl). 2006 Aug;47(8):853-6. doi: 10.1007/s00108-006-1632-9.
Diagnosis of all types of cutaneous tuberculosis is challenging because the clinical picture of these diseases is highly variable. We describe the case of a 79-year old woman with an atypical presentation of Erythema induratum Bazin (EIB) on the chest and left arm in association with a tuberculous osteomyelitis of the left olecranon. Surprisingly, M. tuberculosis grew also from biopsies of the EIB-lesions. This contradicts the conventional view that considers EIB (a tuberculid) to be caused by a hypersensitivity reaction to mycobacteria. The presented case supports the hypothesis that EIB may also be caused by hematogenous or lymphatic spread of viable M. tuberculosis.
各类皮肤结核的诊断颇具挑战性，因为这些疾病的临床表现高度多变。我们描述了一位79岁女性的病例，其胸部和左臂出现不典型的硬结性红斑（EIB），并伴有左尺骨鹰嘴结核性骨髓炎。令人惊讶的是，结核分枝杆菌也从EIB病变的活检组织中培养出来。这与传统观点相悖，传统观点认为EIB（一种结核疹）是由对分枝杆菌的超敏反应引起的。该病例支持了EIB也可能由活的结核分枝杆菌经血行或淋巴扩散所致的假说。
