TWO CASES OF HEMATOGENOUSLY DISSEMINATED SUBCUTANEOUS TUBERCULOUS A BSCESSES

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  • 血行性に皮下に結核性膿瘍を示した2症例
  • ケッコウセイ ニ ヒカ ニ ケッカクセイ ノウヨウ オ シメシタ 2 ショウレイ

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Mycobacterium tuberculosis rarely attacks subcutaneous tissue. Two cases of subcutaneous tuberculous abscess which may have occured through hematogenous seeding are reported.<BR>Case I, 41-year-old female. In 1967, she had arthralgia, myositis, proteinuri a, fever and later sclerodactyly. The diagnosis was the overlapping syndrome of S. L. E. and P. S. S., for which Paramethason was prescribed. She was admitted again in October, 1969, with a fivemonth history of fever, cough and dyspnea. Sputum on admission was proved to contain Mycobacterium tuberculosis (Gaffky II) by smear and also positive on culture. A regimen of SM, PAS, and INH was immediately instituted. In December, fever recurred and subcutaneous masses with fluctuation appeared on the right thigh, sacral and scapular regions. Pus exhibited Mycobacterium tuberculosis on culture.<BR>Case II, 59-year-old female. In 1963 she had an operation for carcinoma of ascending colon. Mytomycin was administered following the operation, and she remained well. In Junuary, 1967, she complained of dyspnea, fever and anemia, and was admitted again in May. The laboratory studies on admission disclosed anemia and urinary infection. Many antibiotics were given, and Kanamycin was most effective and fever was subsided. However fever recurred in September. The antibiotics were given again, but the fever persisted. Examination of urine and chest rentogenogram was negative. Subcutaneous masses developed at left supramandibular, left forearm and abdominal regions. She died on 13th of October.

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