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Clinicopathological features and the practice of diagnosing infectious cutaneous granulomas in Egypt.

Abstract

OBJECTIVE: To present the clinicopathological features and the practice of diagnosing infectious cutaneous granulomas in Egypt.

METHODS: This study included all cases diagnosed with infectious cutaneous granuloma during the period 2004-2010 at Al-Hussein University Hospital, Cairo. Clinical and histological features were recorded, along with the positivity rate (PR) for each diagnostic method.

RESULTS: This study included 233 cases (150 males and 83 females) with a mean age of 47 years. Three groups of infection were recorded: bacterial infections (73.8% Mycobacterium and 3.9% non-Mycobacterium), parasitic infestations (16.7%), and deep fungal infections (5.6%). Tuberculosis cases formed the largest granuloma group (40.8%), followed by leprosy (31.7%) and leishmaniasis (15.9%). A total of 36 cases were diagnosed by direct smear (PR 15.5%), 61 cases by skin biopsy (PR 31.0%), 84 cases by intradermal test (PR 63.6%), 26 cases by serological tests (PR 60.5%), 18 cases by tissue culture (PR 69.2%), and eight cases by PCR (PR 100%).

CONCLUSIONS: Mycobacterial infections constitute the most common infectious cutaneous granulomas among Egyptians. Routine methods such as direct smear, skin biopsy, and intradermal tests remain the most commonly applied and economical methods for diagnosis in developing countries, although specific methods such as tissue culture and PCR have higher positivity rates in the diagnosis.

More information

Type
Journal Article
Author
El-Khalawany M
Meraag I
Eassa B
El-Naby HH