Tuberculosis cutis miliaris disseminata

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.

  • Hematogenic sowing of tubercle bacteria leads to miliary tuberculosis.
  • There are plenty of pathogens in the cutaneous lesions.

  • Partially ulcerating, dense erythematous-brownish, haemorrhagic papules.
  • Enormous involvement is possible. 

  • Travel medical history
  • Clinic.
  • Tuberculin test.
  • Tuberculin test (Mendel-Mantoux) often negative.
  • Quantiferon test.

  • Biopsy.

To exclude system involvement::

  • Thorax X-ray or CT thorax.
  • Sonography of the abdomen and kidneys.
  • 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!).

  • Bronchoalveolar lavage (BAL).

In most cases, disseminated organ infestation occurs.

  1. Barbagallo J, Tager P, Ingleton R, Hirsch RJ , Weinberg JM. Cutaneous tuberculosis: diagnosis and treatment. Am J Clin Dermatol 2002;3:319-28.
  2. Rietbroek RC, Dahlmans RP, Smedts F, Frantzen PJ, Koopman RJ , van der Meer JW. Tuberculosis cutis miliaris disseminata as a manifestation of miliary tuberculosis: literature review and report of a case of recurrent skin lesions. Rev Infect Dis 1991;13:265-9.
  3. Libraty DH , Byrd TF. Cutaneous miliary tuberculosis in the AIDS era: case report and review. Clin Infect Dis 1996;23:706-10.
  4. Handog, E. (2016). Cutaneous manifestations of tuberculosis. Uptodate.com. Retrieved 24 May 2016, from http://www.uptodate.com/contents/cutaneous-manifestations-of-tuberculosis?source=search_result&search=tuberkulosis+skin&selectedTitle=1~16
  5. Haas, W. (2016). RKI - RKI-Ratgeber für Ärzte - Tuberkulose. Rki.de. Retrieved 24 May 2016, from https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Tuberkulose.html#doc2374486bodyText3