Successful Treatment of Relapse Cutaneous Tuberculosis on Pregnant Woman with Ethambutol Allergic

Authors

  • Jahja T Widjaja Immanuel Hospital, Bandung
  • Dian Puspitasari Immanuel Hospital, Bandung
  • Evelyn Nathania Ikatan Dokter Indonesia

DOI:

https://doi.org/10.28932/jmh.v5i2.4985

Keywords:

cutaneous, tuberculosis, pregnant woman, allergy

Abstract

Tuberculosis infection among pregnant women often reveals unspecific clinical manifestations, and cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis. The aim of this case report is to manage well Extra-Pulmonary tuberculosis manifestation, especially in pregnant women. A Pregnant woman with a gestational age of 6-7 weeks complained of red spots on cheeks. One year ago, the patient suffered cutaneous tuberculosis and was only treated with Rifampicin, Isoniazid, and Levofloxacin; pyrazinamide and ethambutol were not given due to a strong suspicion of allergy. Physical examination revealed plaque with scales, and PCR examination revealed Mycobacterium tuberculosis. She suffered relapse of cutaneous tuberculosis and was given rifampicin, isoniazid, and pyrazinamide. After 2 weeks the skin lesion improved significantly, and ethambutol was added to the regimen. The patient suffered from drug eruption, ethambutol was discontinued, and the skin lesion disappeared after four months of treatment. The regiment was continued for one year; showed better condition and delivered a healthy baby boy. Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis (1-1.5%) and is hard to diagnose and treat, especially in pregnant women. Allergic to one of its drugs can increase its risk of being resistant and increase its mortality and morbidity. As conclusion, prompt treatment is needed for tuberculosis patients, especially pregnant women. Early detection and examinations are required to diagnose it properly.

Downloads

Download data is not yet available.

References

Indonesia KKR. Pedoman Nasional Pelayanan Kedokteran Tata Laksana Tuberkulosis. 2020;

Organization(WHO) WH. Global Tuberculosis Report 2019. Geneva; 2019.

Dias MFRG, Bernardes Filho F, Quaresma MV, do Nascimento LV, Nery JA da C, Azulay DR. Update on cutaneous tuberculosis. Vol. 89, Anais Brasileiros de Dermatologia. 2014. 925–938 p.

Sugarman J, Colvin C, Moran AC, Oxlade O. Tuberculosis in pregnancy: An estimate of the global burden of disease. In: The Lancet Global Health [Internet]. Sugarman et al. Open Access article distributed under the terms of CC BY-NC-SA; 2014. p. 710–6. Available from: http://dx.doi.org/10.1016/S2214-109X(14)70330-4

Khadka P, Koirala S, Thapaliya J. Cutaneous Tuberculosis: Clinicopathologic Arrays and Diagnostic Challenges. Dermatol Res Pract. 2018;2018.

van der Walt M, Masuku S, Botha S, Nkwenika T, Keddy KH. Retrospective record review of pregnant women treated for rifampicin-resistant tuberculosis in South Africa. PLoS One [Internet]. 2020;15(9 September):1–9. Available from: http://dx.doi.org/10.1371/journal.pone.0239018

Pebriany D, Anwar AI, Djamaludin W, Adriani A, Amin S. Successful diagnosis and management of tuberculosis verrucosa cutis using antituberculosis therapy trial approach. Pan Afr Med J. 2020;37(216):1–8.

USAID. Indonesia Tuberculosis Roadmap Overview, Fiscal Year 2021. USAID From Am People. 2021;3.

M. ACRMA. Cutaneous Tuberculosis [Internet]. StatPearls Publishing LLC; 2021. 1–7 p. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482220/#_NBK482220_pubdet_

Franco-Paredes C, Marcos LA, Henao-Martínez AF, Rodríguez-Morales AJ, Villamil-Gomez WE, Gotuzzo E, et al. Cutaneous mycobacterial infections. Clin Microbiol Rev. 2019;32(1):1–25.

Granado J, Catarino A. Cutaneous tuberculosis presenting as lupus vulgaris. Int J Infect Dis [Internet]. 2020;96:139–40. Available from: https://doi.org/10.1016/j.ijid.2020.03.069

Mei Y, Zhang W, Shi Y, Jiang H, Chen Z, Chokkakula S, et al. Cutaneous tuberculosis and nontuberculous mycobacterial infections at a national specialized hospital in China. Acta Derm Venereol. 2019;99(11):997–1003.

Kumar B, Dogra S. Cutaneous tuberculosis. Ski Infect Diagnosis Treat. 2017;(7):59–75.

Dos Santos JB, Ferraz CE, da Silva PG, Figueiredo AR, de Oliveira MH, de Medeiros VLS. Cutaneous Tuberculosis: Diagnosis, Histopathology and Treatment - Part II. In: Anais Brasileiros de Dermatologia [Internet]. 2014. p. 545–55. Available from: http://www.scielo.br/pdf/abd/v89n4/0365-0596-abd-89-04-0545.pdf

Belgaumkar VA, Chavan RB, Suryataley PR, Salunke AS, Patil PP, Borade SM. Tuberculosis verrucosa cutis: case report of a diagnostic challenge. Int J Res Dermatology. 2018;4(2):265.

Balasopoulou A, Kokkinos P, Pagoulatos D, Plotas P, Makri OE, Georgakopoulos CD, et al. Symposium Recent advances and challenges in the management of retinoblastoma Globe-saving Treatments. BMC Ophthalmol [Internet]. 2017;17(1):1. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28331284%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC5354527%5Cnhttp://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-11-49%5Cnhttp://bmcophthalmol.biomedcentral.com/articles/10.1186/s12886

Wedy GF, Passero LFD, Criado PR, Belda W. A case of tuberculosis verrucosa cutis in Brazil undiagnosed for 15 years. Brazilian J Infect Dis. 2021;25(3):3–5.

Hehanussa A, Lawalata T, Kartini A, Kandou RT. Diagnosis Skrofuloderma dan Tuberkulosis Kutis Verukosa pada Seorang Pasien ( Diagnosis of Skrofuloderma and Verrucous Tuberculosis Cutis One Patient ). Bikkk. 2019;22(3):221–6.

Perhimpunan Dokter Paru Indonesia (PDPI). Panduan Praktik Klinik (PPK) SINDROM PERNAPASAN PASCACOVID-19. 2021;(19).

Guo D. Severe Skin Rash and Liver Toxic Effects Caused By First-Line Anti-Tuberculosis Drugs: A Case Report. Int J Complement Altern Med. 2017;5(4):1–4.

Downloads

Published

2023-08-31

How to Cite

1.
Widjaja JT, Puspitasari D, Nathania E. Successful Treatment of Relapse Cutaneous Tuberculosis on Pregnant Woman with Ethambutol Allergic. J. Med. Health [Internet]. 2023Aug.31 [cited 2024May21];5(2):169-78. Available from: https://journal.maranatha.edu/index.php/jmh/article/view/4985

Issue

Section

Articles