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Abstract：
We describe an unusual case of posttransplant tuberculosis reactivation in a man who underwent allogeneic hematopoietic cell transplant. Concomitant with disseminated adenovirus infection, reactivation of tuberculosis manifested as disseminated, nonfollicular pustules on day +49. Skin biopsy was obtained on day +50. Initial histopathologic evaluation did not suggest mycobacterial infection, but tissue stain showed acid-fast organisms, which were subsequently identified as Mycobacterium tuberculosis. Shortly after the cutaneous presentation of tuberculosis, the patient died on day +52. Our case is among a paucity of reports describing tuberculosis reactivation in hematopoietic cell transplant patients in the early posttransplant period. It highlights the difficulty of diagnosing contemporaneous systemic infections, and it presents a rare and atypical cutaneous manifestation of tuberculosis in a hematopoietic cell transplant patient. Our case and review of the literature emphasize the need for further research to elucidate risk factors associated with early posttransplant reactivation of tuberculosis, and the importance of remaining vigilant for active tuberculosis in hematopoietic cell transplant patients with epidemiologic risk factors.
摘要：
我们描述了接受异基因造血细胞移植的男性移植后结核病再激活的不寻常病例。伴有播散性腺病毒感染，表现为播散的结核病的重新激活，第49天的非滤泡脓疱。在第+50天获得皮肤活检。最初的组织病理学评估未提示分枝杆菌感染，但是组织染色显示抗酸生物，随后被鉴定为结核分枝杆菌。结核病的皮肤表现后不久，患者在+52天死亡。我们的病例很少有报道描述移植后早期造血细胞移植患者的结核病再激活。它突出了诊断同期全身感染的困难，它在造血细胞移植患者中表现为结核病的罕见和非典型皮肤表现。我们的案例和文献综述强调需要进一步研究以阐明与移植后早期结核病再激活相关的危险因素。以及在有流行病学危险因素的造血细胞移植患者中，对活动性结核病保持警惕的重要性。
