Orificial tuberculosis: detection by polymerase chain reaction.

Orificial tuberculosis (OT) is a rare manifestation of cutaneous tuberculosis in immunocompromised individuals. Due to its variable clinical features, the diagnosis may be missed at the onset of the disease. We report a 53-year-old patient who had OT and miliary spread of Mycobacterium tuberculosis to the lungs, liver, bones and skin. The diagnosis was established by polymerase chain reaction (PCR) amplification of a Mycobacterium-specific gene segment, and confirmed by culture. PCR allows the detection of mycobacterial DNA within a few days, whereas culture takes many weeks. PCR may improve the accurate diagnosis of skin tuberculosis and allow early treatment.