Tuberculosis cutis miliaris disseminata
Last Updated: 2019-08-26
ICD11: -
Last Updated: 2019-08-26
Author(s): Anzengruber F., Navarini A.
ICD11: -
Cutaneous miliary tuberculosis.
Miliary tuberculosis of the skin due to haematogenic sowing. This occurs primarily in immunosuppressed patients or children or the elderly.
In particular, infants, young children, the elderly and immunocompromised people are affected.
Enormous involvement is possible.
Quantiferon test.
Biopsy.
To exclude system involvement::
In the morning (fasting up to 4h) on 3 consecutive days, sputum must be collected.
In the morning on 3 consecutive days urine must be given (fluid restriction the evening before!).
In most cases, disseminated organ infestation occurs.
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!
Consolidation phase:
Induction phase (2 months):
Ethambutol p.o. 15 mg/kg bw/d (may be omitted if isoniazid resistance has been excluded)
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