Disseminated miliary tuberculosis of the skin in patients with AIDS: Report of four cases

G. L. Daikos, R. B. Uttamchandani, C. Tuda, M. A. Fischl, N. Miller, T. Cleary, M. J. Saldana

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38 Scopus citations


We present clinical, bacteriologic, and pathological findings for four patients with AIDS and cutaneous miliary tuberculosis. All patients had generalized tuberculosis with hematogenous dissemination to multiple organs including the skin. Microscopic examination of the skin lesions revealed ill- formed or no granulomata, extensive necrosis, and numerous acid-fast bacilli. Mycobacterium tuberculosis was detected in the skin lesions by cultures for three patients and by polymerase chain reaction for one. Three of the isolates were resistant to at least isoniazid and rifampin, and one was susceptible to these drugs. The outcome was rapidly fatal for the three patients with multidrug-resistant tuberculosis. This report draws attention to the reappearance of a once-rare manifestation of disseminated tuberculosis which, in the setting of advanced human immunodeficiency virus disease, may offer the first indication of infection with multidrug-resistant M. tuberculosis and a poor prognosis.

Original languageEnglish (US)
Pages (from-to)205-208
Number of pages4
JournalClinical Infectious Diseases
Issue number1
StatePublished - 1998

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases


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