Systemic tuberculosis with skin compromise in a pediatric patient with primary immunodeficiency

Authors

  • John A. Cabrera-Enriquez Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima 15024 Perú; Servicio de Clínica Pediátrica. Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú https://orcid.org/0000-0002-0770-505X
  • L. Andrea Huanca-Carreño Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima 15024 Perú; Clínica San Felipe. Lima, Perú
  • Luis Edgardo Gonzales-Huerta Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima 15024 Perú

DOI:

https://doi.org/10.35434/rcmhnaaa.2023.164.2377

Keywords:

Primary Immunodeficiency Disorder, Extrapulmonary Tuberculosis, Cutaneous Ulcer, Tumor Necrosis Factor Receptors, Genetic Predisposition to Disease

Abstract

Background: Primary immunodeficiencies (PID) represent challenging pathologies in terms of diagnosis and treatment, with increased predisposition to recurrent respiratory and gastrointestinal infections.

Case report: A paediatric patient with pathologic variants of genes IFNGR1 and TNFRSF13B, presented an atypical manifestation of tuberculosis, characterized by cutaneous lesions and lack of respiratory symptoms. Patient was initially treated for an atypical mycobacterial infection with partial favourable response. Following microbiological confirmation of Mycobacterium tuberculosis, a proper antibiotic regimen was initiated, resulting in complete recovery.

Conclusion: PIDs increase the likelihood of atypical presentations of tuberculosis, complicating diagnosis and interfering with timely treatment. We report a case lacking the classic clinical criteria for immunodeficiency and with an atypical clinical presentation for M. tuberculosis infection, which led to a 2-month delay in the initiation of the most effective treatment.

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Author Biographies

John A. Cabrera-Enriquez , Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima 15024 Perú; Servicio de Clínica Pediátrica. Hospital Nacional Guillermo Almenara Irigoyen. Lima, Perú

a. Médico Especialista en Enfermedades Infecciosas y Tropicales

L. Andrea Huanca-Carreño, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima 15024 Perú; Clínica San Felipe. Lima, Perú

a. Médica Especialista en Medicina de Emergencias y Desastres

Luis Edgardo Gonzales-Huerta, Carrera de Medicina Humana, Facultad de Ciencias de la Salud, Universidad San Ignacio de Loyola, Lima 15024 Perú

a. Doctor of Philosophy (PhD) in Clinical Medicine Research (Infectious Diseases)

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Published

2024-02-07

How to Cite

1.
Cabrera-Enriquez JA, Huanca-Carreño LA, Gonzales-Huerta LE. Systemic tuberculosis with skin compromise in a pediatric patient with primary immunodeficiency. Rev. Cuerpo Med. HNAAA [Internet]. 2024 Feb. 7 [cited 2024 Nov. 21];16(4). Available from: https://cmhnaaa.org.pe/ojs/index.php/rcmhnaaa/article/view/2377