Tuberculosis cutis colliquativa
Last Updated: 2019-08-26
ICD11: -
Last Updated: 2019-08-26
Author(s): Anzengruber F., Navarini A.
ICD11: -
Skrofuloderm, Skrophuloderm, Scrofuloderm, Skrophuloderm.
Cutaneous tuberculosis form which can lead to melting and subcutaneous fistula formation.
Especially in immunocompromised patients and the elderly as well as children.
Especially per continuitatem (in organ tuberculosis), more rarely exogenous, developing skin tuberculosis.
Thorax X-ray or CT thorax.
In the morning (fasting up to 4h) on 3 consecutive days sputum must be collected.
In the morning, give urine on 3 consecutive days (fluid restriction the evening before!).
Bronchoalveolar lavage (BAL).
Thorax X-ray or CT thorax.
Sonography of the abdomen and kidneys.
Central colliquation necroses and peripheral tuberculoid granulomas are visible.
Recurrent node eruptions possible.
Therapy schedule:
The initial phase should last 8 weeks/2 months. During this time, the majority of bacteria are killed. In the following therapy phase (which lasts for months), an attempt is made to eliminate the remaining bacteria. The antituberculous therapy should be continued for at least 2 months after the absence of skin symptoms.
The therapy should last individually between 12-24, but at least 6 months!
Induction phase (2 months):
Pyrazinamid p.o. 35 mg/ bw/ d if necessary combination with allopurinol!
Ethambutol p.o. 15 mg/kg bw/ d
A clear improvement can be seen in the vast majority of cases after 1 month at ½ .
· Consolidation phase:
Isoniazid p.o. 5 mg/kg bw. (with Vit B 6)
Ethambutol p.o. 15 mg/kg bw/d (may be omitted if isoniazid resistance has been excluded)
HIV Patients: Therapy must be done at ≥ for 7 months. Ethambutol should be replaced by streptomycin p.o. 15-20 mg/kg bw/d (from > 60 years max 750 mg) in case of additional therapy with NNRTI.
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