Cutaneous tuberculosis diagnosis in an inhospitable Amazonian region by means of telemedicine and molecular biology

We report on a 13-year-old boy who displayed a chronic granulomatous inflammatory reaction of 5 years duration. The lesion was resistant to different antibiotic schemes; his routine laboratory tests and chest radiographs were normal. Teledermatologic consultation and histopathologic study of skin bi...

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Bibliographic Details
Published in:Journal of the American Academy of Dermatology 2005-05, Vol.52 (5), p.S65-S68
Main Authors: Angel, Diana I., Alfonso, Rosalba, Faizal, Michel, Ricaurte, Orlando, Baez, Julio A., Rojas, Andres, Barato, Paola, Patarroyo, Manuel E., Patarroyo, Manuel A.
Format: Article
Language:English
Subjects:
Adolescent
Bacterial diseases
Biological and medical sciences
Biopsy
Colombia
Dermatology
DNA, Bacterial - analysis
Human bacterial diseases
Humans
Infectious diseases
Lymph Nodes - microbiology
Lymph Nodes - pathology
Male
Medical sciences
Mycobacterium tuberculosis - genetics
Mycobacterium tuberculosis - isolation & purification
Polymerase Chain Reaction
Rural Population
Telemedicine
Tuberculosis and atypical mycobacterial infections
Tuberculosis, Cutaneous - pathology
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Summary:We report on a 13-year-old boy who displayed a chronic granulomatous inflammatory reaction of 5 years duration. The lesion was resistant to different antibiotic schemes; his routine laboratory tests and chest radiographs were normal. Teledermatologic consultation and histopathologic study of skin biopsy suggested scrofulodermal tuberculosis. Polymerase chain reaction amplification of DNA extracted from lymph node biopsy was taken as starting material for dot-blot hybridization using Mtp-40 and IS 6110 as probes for detecting either Mycobacterium tuberculosis or any mycobacteria belonging to the M tuberculosis complex, respectively. Positive results in both hybridizations were further confirmed by culturing in BACTEC MGIT 960 system. The lesion greatly diminished following isoniazid, rifampin, and ethambutol treatment. Telemedicine allowed a cutaneous tuberculosis diagnosis to be made of a patient living in a remote town located in the Amazon jungle by using molecular biology techniques.
ISSN:0190-9622
1097-6787
DOI:10.1016/j.jaad.2004.07.048