Tuberculous primary complex

Last Updated: 2023-07-07

Author(s): Anzengruber F., Navarini A.

ICD11: 1B10.1

Tuberculous chancre.

Mostly occurring in the intestine, lungs and rarely on the skin, primary complex on first contact with the pathogen.

It occurs mainly in children in endemic areas.

  • When the immune system is usually intact, initial contact with the pathogen occurs. Spontaneous healing is extremely rare. Light skin defects can often be the cause.
  • Incubation period
  • 3-4 weeks.

  • Localisations
    • Face, gluteal, extremities.
  • At the site of entry, there may be the appearance of a small papule or nodule (ggl. > 5 cm in size) which ulcerates in the course. Even after weeks, no healing is in sight.
  • Locoregional lymph node adenopathy and lymphangitis. Meltdown and perforation may occur.
  • Feeding tuberculosis is called an infection caused by contaminated milk and subsequent tonsil infection. The tonsillar change (primary infection) is rather inconspicuous, while locoregional lymph node adenopathy is visible cervically.
  • Circumcision tuberculosis: Tuberculosis infection, which occurs in the context of circumcision.

  • Anamnesis (contact with contaminated milk, infected person, etc.).
  • Clinical.
  • Bact.
  • Biopsy (both dermatopathological and microbiological examination).
  • Tuberculin test (Mendel-Mantoux).
  • Quantiferone test.
  • If necessary, e.g. systemic involvement.
  • Thoracic X-ray or CT thorax.
  • Sonography of the abdomen and kidneys.
  • Collect sputum in the morning on 3 consecutive days (fasting up to 4h).
  • Pass urine in the morning on 3 consecutive days (fluid restriction the evening before!).
  • Bronchoalveolar lavage (BAL).

Initially uncharacteristic. After about 1 month, tuberculous granulomas first appear.

  • Healing after 1-3 months.
  • Lupus vulgaris or erythema nodosum may develop.

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