History and clinical findings: After a trivial injury, a male patient from India presented with a non-healing minor injury. A necrotic lesion at the right medial ankle was evident.
Examinations: Mycobacterium tuberculosis complex was detected from tissue material both in cultures and by molecular markers. Sonography of the abdomen indicated a retroperitoneal abcess formation.
Diagnosis, treatment and course: Cutaneous tuberculosis with involvement of the spine and an abscess of the psoas muscle was diagnosed. After initiation of antituberculotic treatment elevation of liver enzymes was noted. The initially observed skin lesion in the area of the right ankle healed quickly; however, the abscess of the psoas muscle did not. The abscess was drained by puncture. During follow up no fistula formation was observed.
Conclusion: Tuberculosis should be considered as differential diagnosis in cases of poorly healing skin lesions caused by trauma, especially in patients from tuberculosis high incidence regions.
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