Deutsche medizinische Wochenschrift (1946) · 2002
[Skin nodules and ulcers of the limbs in a patient with rheumatoid arthritis].
Клинический случайАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Böcher W, Galle P R, Märker-Hermann E
Аннотация
CASE HISTORY: While being treated with corticosteroids and methotrexate for rheumatoid arthritis, a 63-year-old man developed livid nodules on his lower arms, hands and feet, as well as fever, necrotizing skin ulcers and rupture of a finger extensor tendon.
INVESTIGATIONS: No vasculitis was found in a biopsy of one of the nodules on the lower arm. Fast growing mycobacteria, classified as M. marinum by PCR, were cultured from wound swabs.
TREATMENT AND COURSE: The lesions healed on administration of ciprofloxacin, ethambutol and clarithromycin as well as local treatment.
CONCLUSION: Cutaneous lesions of an atypical mycobacterial infection are often misdiagnosed. This is especially so in immunocompromised patients and in the differential diagnosis of vasculitis.
INVESTIGATIONS: No vasculitis was found in a biopsy of one of the nodules on the lower arm. Fast growing mycobacteria, classified as M. marinum by PCR, were cultured from wound swabs.
TREATMENT AND COURSE: The lesions healed on administration of ciprofloxacin, ethambutol and clarithromycin as well as local treatment.
CONCLUSION: Cutaneous lesions of an atypical mycobacterial infection are often misdiagnosed. This is especially so in immunocompromised patients and in the differential diagnosis of vasculitis.
Предметные рубрики MeSH
Anti-Bacterial AgentsAnti-Infective AgentsAntirheumatic AgentsAntitubercular AgentsArthritis, RheumatoidBiopsyCiprofloxacinClarithromycinDiagnosis, DifferentialDrug Therapy, CombinationEthambutolExtremitiesGlucocorticoidsHumansImmunocompromised HostMaleMethotrexateMiddle AgedMycobacterium Infections, NontuberculousMycobacterium marinumPrednisoloneSkin Diseases, BacterialSkin UlcerVasculitis