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Skin, ear and testis – unusual sites of tuberculosis

Cătălina Elena Ene, Claudia Toma, Ionela Belaconi, Ștefan Dumitrache-Rujinski, Daniela Jipa, Adrian Tudor, Diana Leonte, Miron Alexandru Bogdan

Abstract: 

Pulmonary localization is the most common site of tuberculosis (TB)and the most contagious form. Extrapulmonary tuberculosis with the rarest and most unexpected localizations represents a significant proportion of all cases of tuberculosis and remains an important public health problem. We report three unusual TB locations: skin, ear and testis occurred in three immunocompetent patients. In the case of skin and testicular lesions, diagnosis was based on pathological confirmation of granulomas with caseous necrosis. In the third case the diagnosis was made possible by identification of positive Acid-Fast Bacilli smear and positive culture from othic drainage fluid. The outcome at all three patients was good with antituberculous  treatment. These unusual localization of tuberculosis also highlight the possibility of extrapulmonary tuberculosis as adifferential diagnosis in many common diseases. 

Keywords: 
extrapulmonary tuberculosis, immunocompetent host, unusual sites

According to the World Health Organization (WHO) there were 9 million new cases of tuberculosis and 1.5 million deaths from this disease in 2013. About one-third of world’s population has latent tuberculosis, this means that people have been infected by Mycobacterium tuberculosis but are not ill at current time(1). People infected with TB bacteria have a lifetime risk of falling ill with tuberculosis of 10%(2). Tuberculosis is a multisystemic disease with various symptoms and manifestations and can affect any organ or tissue. Lung involvement is the most common and highly contagious form. Extrapulmonary tuberculosis with its rarest and most unexpected localizations is still a significant proportion of all cases of tuberculosis with difficult positive diagnosis and remains an important public health problem.

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