Paucibacillary Cutaneous Tuberculosis Diagnosed Using GeneXpert MTB/RIF Ultra: A Case Report

Kholoud Maafi; Hamza Abidar; Karim Souly; Souad Aboudkhil

doi:10.63095/NBSEH.26.824915

Authors

Kholoud Maafi Laboratory of Biotechnology, Agri-Food, Materials and Environment, Faculty of Science and Technology Mohammedia, Hassan II University of Casablanca, Mohammedia, Morocco (ROR: https://ror.org/001q4kn48); Ibn Sina University Hospital in Rabat, Rabat, Morocco (ROR: https://ror.org/038zpvz53); Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco (ROR: https://ror.org/00r8w8f84); Pasteur Institute of Morocco, Casablanca, Morocco (ROR: https://ror.org/04yb4j419)
Hamza Abidar Ibn Sina University Hospital in Rabat, Rabat, Morocco (ROR: https://ror.org/038zpvz53); Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco (ROR: https://ror.org/00r8w8f84).
Karim Souly Ibn Sina University Hospital in Rabat, Rabat, Morocco (ROR: https://ror.org/038zpvz53); Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco (ROR: https://ror.org/00r8w8f84).
Souad Aboudkhil Laboratory of Biotechnology, Agri-Food, Materials and Environment, Faculty of Science and Technology Mohammedia, Hassan II University of Casablanca, Mohammedia, Morocco (ROR: https://ror.org/001q4kn48)

DOI:

https://doi.org/10.63095/NBSEH.26.824915

Keywords:

GeneXpert MTB/RIF, Cutaneous Tuberculosis, Scrofuloderma

Abstract

Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis, often paucibacillary and with a polymorphic clinical presentation, making diagnosis difficult. We report the case of a 32-year-old immunocompetent woman, vaccinated with BCG, with a history of treated neuromeningeal tuberculosis, who developed a progressively worsening left cervicothoracic skin lesion. Clinical examination revealed an isolated inflammatory nodule without any alteration in her general condition. Conventional microbiological tests, including sputum smear microscopy and culture, were negative. But, molecular analysis by GeneXpert MTB/RIF Ultra on a skin biopsy detected Mycobacterium tuberculosis DNA at a low load, without rifampicin resistance, confirming paucibacillary cutaneous tuberculosis of the secondary scrofuloderma type. Standard antituberculosis treatment resulted in a favourable outcome without relapse. This case highlights the value of molecular techniques in the early diagnosis of atypical forms of extrapulmonary tuberculosis.

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