Abstract
Introduction: Chronic cutaneous lesions are common in immunocompromised patients and are attributable to a wide range of potential microbial pathogens. Common infections may have a variety of unusual manifestations, and unusual pathogens can also play an important role in these infections. Therefore, “how to approach” these lesions becomes a difficult problem. Case Report: A 42-year-old male had medical history of immune thrombocytopenic purpura (ITP), chronic hepatitis C with liver cirrhosis, Child’s-Pugh-Turcotte score A, and end stage renal disease requiring maintenance hemodialysis. The patient also suffered from multiple ecchymoses and tender plaques on all four limbs for one month. A pathology of skin biopsy showed lobular panniculitis and a strong positive finding of acid-fast bacilli (AFB). A bone marrow biopsy also showed a strong positive finding of AFB but no granulomatous inflammation. The patient was treated as disseminated tuberculosis infection and experienced anti-tuberculosis (TB) drug
Highlights
Chronic cutaneous lesions are common in immunocompromised patients and are attributable to a wide range of potential microbial pathogens
Common infections may have a variety of unusual manifestations, and unusual pathogens can play an important role in these infections
We should consider non-tuberculous mycobacteria (NTM) infection if a clinical condition does not improve after several months of anti-TB therapy
Summary
Chronic cutaneous lesions are common in immunocompromised patients and are attributable to a wide range of potential microbial pathogens. There are difficulties regarding how to survey and treat immunocompromised patients due to multiple side effects and comorbidities. NTM has been characterized as an emerging pathogen. Conclusion: Cutaneous lesions in immunocompromised patients are complex because of a wide range of potential microbial pathogens. Common infections may have unusual manifestations in immunocompromised patients. The NTM is an emerging opportunistic pathogen in severely immunocompromised patients with acquired immunodeficiency syndrome or a transplantation in recent years. The incidence of pulmonary or extrapulmonary NTM infection has increased dramatically in recent years. We should consider NTM infection if a clinical condition does not improve after several months of anti-TB therapy.
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