RESUMO
Cutaneous tuberculosis is a rare extrapulmonary pre-sentation of tuberculosis, caused by mycobacterial species of the Mycobacterium tuberculosis complex. We describe a case of cutaneous tuberculosis in a 57-year-old technician from the microbiology laboratory in our hospital. She accidentally experienced a needlestick injury with a hollow needle while at work. Skin lesion developed shortly after on the punctured finger. A biopsy was performed, revealing necrotizing (caseating) granulomatous inflammation. Pharmacological treatment was initiated with four standard drugs: isoniazid, rifampicin, pyrazinamide, and ethambutol hydrochloride. Improvement was observed, but the initial treatment had to be suspended due to intolerance to some of the drugs and changed to a treatment with isoniazid, rifampicin, and levofloxacin. The long duration of the treatment may increase the risk of toxic effects, making it necessary to discard the drug causing these effects and change the treatment regimen.
Assuntos
Isoniazida , Rifampina , Feminino , Humanos , Pessoa de Meia-Idade , Etambutol , Biópsia , Atenção à SaúdeRESUMO
La tuberculosis cutánea es una presentación extrapulmonar poco común de la tuberculosis, producida por la infección por especies de micobacterias del complejo Mycobacterium tuberculosis. Se presenta un caso de tuberculosis cutánea en una trabajadora de 57 años, Técnico Especialista de Laboratorio en el Servicio de Microbiología, tras sufrir accidente de trabajo por pinchazo accidental con aguja hueca. Al poco tiempo desarrolló lesión cutánea en el dedo que fue biopsiada e informada de inflamación granulomatosa necrotizante (caseificante). Se inició tratamiento con cuatro fármacos: isoniazida, rifampicina, pirazinamida y etambutol hidrocloruro, con mejoría cutánea y fue suspendido por mala tolerancia, cambiando el tratamiento a isoniazida, rifampicina y levofloxacino. Debido a la larga duración del tratamiento, existe riesgo de aparición de algún efecto tóxico que obligue a prescindir definitivamente del fármaco causante y cambiar la pauta.(AU)
Cutaneous tuberculosis is a rare extrapulmonary pre-sentation of tuberculosis, caused by mycobacterial species ofthe Mycobacterium tuberculosis complex. We describe a caseof cutaneous tuberculosis in a 57-year-old technician fromthe microbiology laboratory in our hospital. She accidentallyexperienced a needlestick injury with a hollow needle whileat work. Skin lesion developed shortly after on the punc-tured finger. A biopsy was performed, revealing necrotizing(caseating) granulomatous inflammation. Pharmacologicaltreatment was initiated with four standard drugs: isoniazid,rifampicin, pyrazinamide, and ethambutol hydrochloride.Improvement was observed, but the initial treatment had tobe suspended due to intolerance to some of the drugs andchanged to a treatment with isoniazid, rifampicin, and levo-floxacin. The long duration of the treatment may increase therisk of toxic effects, making it necessary to discard the drugcausing these effects and change the treatment regimen.(AU)
