PULMONARY TUBERCULOSIS CO-EXISTING WITH LUPUS VULGARIS AND CUTANEOUS MYIASIS- A RARE CASE REPORT

Dr. Navaneethan Manohar, Dr. Ilakkia Priya Sadasivam*, Dr. Lisa Jennifer D’souza, Dr. Rajkiran Takharya, Dr. Bhavana Sampadarao and Dr. Gayathri Jayabalan

ABSTRACT

The lung is the most common primary organ in tuberculosis (TB) infection. Cutaneous tuberculosis is a rare extrapulmonary type that accounts for only 1%–2% of total TB cases, usually limited to the skin. But in immunocompromised patients, it can be multifocal. Lupus vulgaris is the common form of cutaneous tuberculosis in which eighty percent of this lesion is distributed over the head and neck with female predominance. Atrophic scarring of lesions and apple jelly colour on diascopy are characteristic. The route of infection of mycobacterium can either spread via hematogenous or via lymphatics. The management of all cutaneous tuberculosis is similar to pulmonary tuberculosis as well as extrapulmonary tuberculosis. Patients with HIV (Human Immunodeficiency Virus) infection is highly likely to present with disseminated disease. The detection of tuberculosis infection in other visceral organs, mainly pulmonary TB, should be worked up simultaneously to prevent further complications and spread. Here, we are going to discuss a rare case report of pulmonary tuberculosis co-existing with Lupus vulgaris and cutaneous myiasis.

Keywords: Lupus Vulgaris, Cutaneous tuberculosis, Pulmonary tuberculosis, Disseminated tuberculosis, Cutaneous Myiasis, Extrapulmonary tuberculosis, Acid fast bacilli, anti-tubercular treatment (ATT), sputum AFB, granuloma, granulomatous lymphadenitis, Maggots.