Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa
Introduction: Tuberculosis (TB) remains a major burden of disease worldwide, especially in Human immunodeficiency virus (HIV)-infected patients. Cutaneous forms of TB account for approximately 10 % of all extrapulmonary tuberculosis cases, with oral manifestations accounting for less than 1 % of the...
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Elsevier
2025-08-01
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| Series: | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405579425000154 |
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| author | Mahlatse Cordelia Kgokolo Mohlominyane Jeffrey Mokheseng Jabulile Johanna Makhubele Shalate Charlotte Siwele Tinashe Irvin Maphosa Tsholofelo Kungoane |
| author_facet | Mahlatse Cordelia Kgokolo Mohlominyane Jeffrey Mokheseng Jabulile Johanna Makhubele Shalate Charlotte Siwele Tinashe Irvin Maphosa Tsholofelo Kungoane |
| author_sort | Mahlatse Cordelia Kgokolo |
| collection | DOAJ |
| description | Introduction: Tuberculosis (TB) remains a major burden of disease worldwide, especially in Human immunodeficiency virus (HIV)-infected patients. Cutaneous forms of TB account for approximately 10 % of all extrapulmonary tuberculosis cases, with oral manifestations accounting for less than 1 % of these cases. A high index of suspicion is essential when diagnosing rare clinical presentations. The response to treatment is excellent in most patients, particularly those receiving concomitant, effective antiretroviral (ARV) treatment. Patient presentation: We report two cases of lupus vulgaris in AIDS patients (CD4 count of 113 cells/mm3 and 172 cells/mm3, respectively) and one case of mucosal TB in a patient with CD4 count of 365 cells/mm3. All the patients were adults referred to the dermatology clinic. The atypical clinical presentations included papules, plaques, and ulcers affecting unusual sites, such as the upper and lower limbs in the case of lupus vulgaris and a tongue ulcer in the patient with oral TB, emphasizing the importance of strong suspicion in HIV-infected patients. All available diagnostic measures were used to confirm the diagnosis. Management: We demonstrate the importance of multidisciplinary care for patients and an excellent response to anti-TB treatment once diagnosed. We also emphasize the importance of concomitant ARV treatment and patient follow-up. Conclusion: The outcomes of two of the three patients were good, highlighting the importance of timely clinical diagnosis and treatment, including monitoring and follow-up, while ensuring continued ARV treatment. |
| format | Article |
| id | doaj-art-6e425b2bea0b4ff2a1cf02d2d3e37ef2 |
| institution | DOAJ |
| issn | 2405-5794 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical Tuberculosis and Other Mycobacterial Diseases |
| spelling | doaj-art-6e425b2bea0b4ff2a1cf02d2d3e37ef22025-08-20T02:48:58ZengElsevierJournal of Clinical Tuberculosis and Other Mycobacterial Diseases2405-57942025-08-014010052410.1016/j.jctube.2025.100524Atypical presentations of mucocutaneous TB in HIV: A case series from South AfricaMahlatse Cordelia Kgokolo0Mohlominyane Jeffrey Mokheseng1Jabulile Johanna Makhubele2Shalate Charlotte Siwele3Tinashe Irvin Maphosa4Tsholofelo Kungoane5Department of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South Africa; Corresponding author.Department of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South AfricaDepartment of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South AfricaDepartment of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South AfricaDepartment of Dermatology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South AfricaDepartment of Oral Pathology and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia 0007, South AfricaIntroduction: Tuberculosis (TB) remains a major burden of disease worldwide, especially in Human immunodeficiency virus (HIV)-infected patients. Cutaneous forms of TB account for approximately 10 % of all extrapulmonary tuberculosis cases, with oral manifestations accounting for less than 1 % of these cases. A high index of suspicion is essential when diagnosing rare clinical presentations. The response to treatment is excellent in most patients, particularly those receiving concomitant, effective antiretroviral (ARV) treatment. Patient presentation: We report two cases of lupus vulgaris in AIDS patients (CD4 count of 113 cells/mm3 and 172 cells/mm3, respectively) and one case of mucosal TB in a patient with CD4 count of 365 cells/mm3. All the patients were adults referred to the dermatology clinic. The atypical clinical presentations included papules, plaques, and ulcers affecting unusual sites, such as the upper and lower limbs in the case of lupus vulgaris and a tongue ulcer in the patient with oral TB, emphasizing the importance of strong suspicion in HIV-infected patients. All available diagnostic measures were used to confirm the diagnosis. Management: We demonstrate the importance of multidisciplinary care for patients and an excellent response to anti-TB treatment once diagnosed. We also emphasize the importance of concomitant ARV treatment and patient follow-up. Conclusion: The outcomes of two of the three patients were good, highlighting the importance of timely clinical diagnosis and treatment, including monitoring and follow-up, while ensuring continued ARV treatment.http://www.sciencedirect.com/science/article/pii/S2405579425000154HIVMycobacteriaLupus vulgarisOral TBTuberculosisAntiretroviral therapy |
| spellingShingle | Mahlatse Cordelia Kgokolo Mohlominyane Jeffrey Mokheseng Jabulile Johanna Makhubele Shalate Charlotte Siwele Tinashe Irvin Maphosa Tsholofelo Kungoane Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa Journal of Clinical Tuberculosis and Other Mycobacterial Diseases HIV Mycobacteria Lupus vulgaris Oral TB Tuberculosis Antiretroviral therapy |
| title | Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa |
| title_full | Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa |
| title_fullStr | Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa |
| title_full_unstemmed | Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa |
| title_short | Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa |
| title_sort | atypical presentations of mucocutaneous tb in hiv a case series from south africa |
| topic | HIV Mycobacteria Lupus vulgaris Oral TB Tuberculosis Antiretroviral therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2405579425000154 |
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