CHSJ

Curr Health Sci J, vol. 52, no. 2, 2026

Cutaneous Tuberculosis in a 22-Day-Old Neonate: A Diagnostic Challenge and Case Report

[Case Report]

A. IMRAN(1), S.W.F. SHAHA(1), S.A.R. SHAH(1), M. RAFIQUE(1), H. RAJA(1)


(1)Dr. Ruth K. M. Pfau, Civil Hospital Karachi, Pakistan


Abstract:

Background: Cutaneous tuberculosis (CTB) is a rare extrapulmonary manifestation of tuberculosis, particularly in neonates. Its diagnosis is often challenging due to non-specific presentations that can mimic common conditions. Clinical Description: We report the case of a 22-day-old male neonate who presented to the emergency room with fever and a scalp swelling following a reported fall from bed. Initial assessment suggested a subcutaneous abscess. The patient did not respond to multiple courses of intravenous antibiotics. A blood culture grew Burkholderia species, but targeted therapy also failed. Incision and drainage were performed, and pus GeneXpert testing was positive for Mycobacterium tuberculosis, despite a negative tuberculin skin test and clear chest X-ray. A final diagnosis of cutaneous tuberculosis (tuberculous chancre) was established. Management & Outcome: Anti-tuberculosis therapy (ATT) was initiated, leading to the complete resolution of the swelling and full recovery. Conclusion: This case underscores the diagnostic challenges of neonatal CTB. It highlights the importance of considering tuberculosis in the differential diagnosis of non-resolving abscesses in infants, especially in endemic areas, and demonstrates the critical role of molecular diagnostics like GeneXpert in achieving a timely diagnosis.


Keywords: Tuberculosis, chancre, cutaneous tuberculosis, mycobacterium tuberculosis, neonatal, diagnostic challenges, genexpert, antitubercular therapy.



Corresponding: Huda Raja, Dr. Ruth K. M. Pfau, Civil Hospital Karachi, e-mail: ccornrh2@gmail.com


DOI 10.12865/CHSJ.52.02.14 - Download PDF
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