Akademik Veri Yönetim Sistemi
TURKISH JOURNAL OF GERIATRICS-TURK GERIATRI DERGISI, cilt.14, sa.2, ss.168-171, 2011 (SCI-Expanded)
Cutaneous tuberculosis (TB) is a rare form of extrapulmonary tuberculosis (EPT) and scrofuloderma is one of the manifestations of cutaneous TB. It is usually caused by fistulization of lymph nodes to the skin. The most common predilection site is the cervical region. A 96 year-old female was admitted with multiple cervical swollen lymp nodes with 10 years duration. The biggest one had fistulized through the skin discharging purulent material. Multiple samples of purulent material were obtained and evaluated by direct light microscopy after Ziehl-Nielsen procedure. Acido-resistant bacilli (ARB) at a level of (++++) were detected in every microscopic field BACTEC and polymerase chain reaction (PCR) analyses were found as positive and microorganism was identified as Mycobacterium tuberculosis. The fistulized lymph node was debrided at the bed-side and pathological examination showed granulomatous lymphadenitis. Four-drug anti-tuberculosis regimen was started immediately. However, although clinical improvement was present, the patient died unexpectedly at the first month of the treatment due to cardiac reasons without any therapy-related complications. In conclusion, scrofuloderma should be suspected in any elderly patient with enlarged lymph nodes along with a fistulization to skin especially in countries where TB is endemic like Turkey, and approached appropriately.