Absceso frío tuberculoso. Revisión de la literatura a propósito de cinco casos en Angola / Tuberculous cold abscess. Literature review on five cases in Angola

RESUMEN Introducción: El absceso frío tuberculoso es la forma clínica más frecuente de tuberculosis cutánea. Objetivo: Familiarizar a los médicos generales con las características clínicas del absceso tuberculoso frío para asegurar su diagnóstico y tratamiento específico en la consulta de Cirugía del Hospital General N'gola Kimbanda en Namibe, Angola en 2018. Método: Se revisó la literatura sobre el tema en bases de datos científicas como Medline, PubMed, SciELO, Scopus, Clinical Key, LILACS con los descriptores: tuberculosis extrapulmonar y absceso frío tuberculoso. Resultados: Los pacientes, tres varones y dos hembras, tres adultos y dos infantes, todos desnutridos, con antecedentes de tuberculosis pulmonar y mal de Pott que fueron enviados a consulta con el diagnóstico de lipoma. En todos los casos se diagnosticó absceso frío tuberculoso, 3 de localización lumbar, 1 toracolumbar y 1 lumbosacra confirmados por microbiología y tratados según los protocolos de las especialidades de Cirugía y Neumología. Conclusiones: Es necesario que los estudiantes de Medicina, médicos generales y especialistas que en su desempeño enfrentan a dichos pacientes dentro y fuera de Cuba se empoderen de las características semiológicas del, también llamado, goma tuberculoso, a fin de identificarlo en los pacientes de riesgo y garantizar su tratamiento médico-quirúrgico específico para evitar la discapacidad y mortalidad asociada a esta temida infección que sigue constituyendo un azote social.

ABSTRACT Introduction: Tuberculous cold abscess is the most common clinical form of skin tuberculosis. Objective: To familiarize general physicians with the clinical characteristics of tuberculous cold abscesses to ensure their diagnosis and specific treatment at the Surgery Department of the N'gola Kimbanda General Hospital in Namibe, Angola in 2018. Method: Literature on the subject was reviewed in scientific databases such as Medline, PubMed, SciELO, Scopus, Clinical Key and LILACS with the following descriptors: extrapulmonary tuberculosis and tuberculous cold abscess. Results: The patients, three males and two females, three adults and two infants, all of them malnourished, with a history of pulmonary tuberculosis and Pott's Disease, who were sent for consultation with a diagnosis of lipoma. In all cases, tuberculous cold abscesses were diagnosed, 3 of them in lumbar location, 1 in thoracolumbar and 1 in lumbosacral locations, confirmed by microbiology and treated according to the protocols of the specialties of Surgery and Pneumology. Conclusions: It is necessary that students of Medicine, general physicians and specialists who face these patients inside and outside of Cuba to gain in knowledge with the semiological characteristics of the tuberculous cold abscess, also known as tuberculous gum, in order to identify it in the patients in risk groups, and to guarantee their specific medical-surgical treatment to avoid the disability and mortality associated to this infection that still constitutes a major issue.

Cutaneous and articular tuberculosis in a renal transplant recipient

Abstract Seven months after undergoing kidney transplantation, a 56-year-old woman presented with papules and ulcers in her right forearm. The patient received antibiotics for 8 months with limited improvement. Eleven months after symptom onset, she presented with acute arthritis in her left knee. Asynovial fluid culture yielded Mycobacterium tuberculosis, and a forearm ulcer biopsy showed granulomatous inflammation. After surgical fistulectomy and 12 months of tuberculosis treatment, she was cured. Chronic cutaneous ulcers and articular manifestations in TB are rare, but they should always be considered in the differential diagnosis for immunosuppressed patients. Surgical intervention and prolonged treatment might be necessary.

Tuberculosis vegetante / Vegetans tuberculosis

Imformamos un caso de tuberculosis vegetante perianal. Un hombre de 59 años presentaba múltiples vegetaciones fistulizadas alrededor del ano y genitales. El disgnóstico fue confirmado por cultivo. La cirugía y agentes tuberculostáticos fueron efectivos. Presentamos una revisión bibliográfica reciente