BACKGROUND: Mycobacterium africanum is a member of the Mycobacterium tuberculosis complex (MTBC) and is endemic in West Africa, where it causes up to half of all cases of pulmonary tuberculosis. Here, we report the first isolation of Mycobacterium africanum from the pericardial effusion culture of a patient with tuberculous pericarditis.
METHODS: A 31-year-old man, native from Senegal, came to the emergency room with massive pericardial effusion and cardiac tamponade requiring pericardiocentesis. M. africanum subtype II was identified in the pericardial fluid. The patient completed 10 months of standard treatment, with a favorable outcome.
CONCLUSIONS: We report the first case of tuberculous pericarditis caused by Mycobacterium africanum, which provide evidence that this microorganism can cause pericardial disease and must be considered in patients from endemic areas presenting with pericardial effusion.

BACKGROUND: There has been an increase in the number of tuberculosis (TB) cases worldwide, but TB of the skin remains rare.
METHODS: A case of 7-year-old girl with multiple ulcerating nodules who presented with four ulcers in the skin of the left elbow. The patient was unresponsive to broad-spectrum antibiotics treatment initially. Because of poor clinical response to conventional therapy, TB was suspected. Although tuberculin skin test was negative, positive QuantiFERON TB Gold test and clinical picture strongly indicated TB. Clinical diagnosis was confirmed by positive culture for Mycobacterium tuberculosis.
CONCLUSIONS: A high index of clinical suspicion is necessary to suspect TB of the skin. Positive culture remains the gold standard for diagnosis.