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More Common Than Tuberculosis

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More common than tuberculosis. From a practical point of view, however, an etiologic diagnosis is usually impossible, and treatment with isoniazid is often administered if the tuberculin test is positive, especially, as is frequently the case, steroid therapy is used. Phiyctenular keratoconjunctivitis is a rare allergic external ocular inflammation observed in children at the time of the primary infection and characterized by small blisters (phlyctenules) at the junction of conjunctiva and cornea, It may be severely exacerbated by tuberculin testing and result in corneal injury.

Choroidal tubercles will often provide a clue to the presence of disseminated tuberculosis.

Cutaneous tuberculosis, once an important, but now only rarely seen, group of illnesses, is usually grouped into two categories. The first, caused by the presence of organisms in the skin, includes lupus vulgaris (a red-brown, thickened, slightly nodular, nonulcerated process, most frequently on the face), tuberculosis verrucosa cutis (anatomic or prosector's wart),  scrofuloderma (the skin changes surrounding a draining tuberculous sinus or overlying a tuberculous node), and tuberculosis officials (nodular and ulcerated lesions around the mouth or other orifice through which highly infectious material passes). All these are granulomatous histologically and are very. responsive to isoniazid alone.

The second group comprises the tuberculids (including erythema induratum of Bazin's disease). These reactions are thought to be based on allergy to a distant bacterial infection. They assume a wide variety of erythematous, popular, and ulcerative forms. Their relationship with tuberculosis is poorly understood. Tuberculosis cutis. miliaris, acute disseminate is a rare complication of overwhelming miliary tuberculosis, usually in children, presenting as a disseminated petechial or purpuric rash, at times with minute papule formation. 

Tuberculosis of the spleen, thyroid, pancreas, and breast may all occur and suggest other infections or neoplastic changes in these organs.

Dukes, R., and Dubos, J.: The White Plague.  A.:  U.S.  VA-Armed Forces cooperative study on the)711g”ruffling.21 7XKilts olf4saiment'=_iliary tuberculosis: A follow-up study of 570 adult patients.Rev. Resp. Dis., 91:6, 1965.il-t-armed forces cooperative study on the chemo-. =craw of tuberculosis. XIII. Tuberculous meningitis in WM* with special reference to survival, neurologic resi and Work status. Amer. Rev. Resp. Dis., 91:823, 1965.

Bone Joint Surg. (Amer 1. 48-A:451, 1966. Goyette, E. M.: Treatment of tuberculous pericarditis. WHO, 21:5, 1909Kaplan, C. J.

Kotaro, P. G., and Blesovsky, A.: The ambulant treatment of spinal tuberculosis. Brit. J. Surg., 50:26, 1962.Lattimer, J. K.: Renal tuberculosis. New Eng. J. Med., 273:208, 1965.Lowell, A. M., Edwards, L. B., and Palmer, C.

Amer. Rev. Reap. Dis: 97:337, 1968.Mitchison, D. A.: Chemotherapy of tuberculosis: A bacteriologist viewpoint. Brit. Med. J., 1:1333, 1965.

Proudfoot, A. T., Akhtar, A. J., Douglas, A. C., and Horne, N. W.: Miliary tuberculosis in adults. Brit. Med. J., 2:273, 1969. Ann. Intern. Med., 67:919, 1967.

Amer. Rev. Resp. New Eng. J. Med., 277:1008, 1967.Stead, W. W.: Amer. Rev. Resp. Die., 95:729, 1967.Twomey, J. J., and Leavell, B. S.: Leukemoid reactions to tuberculosis. Arch. Intern. Met (Chicago), 116:21, 1965.Varma, B. N., and Smith, J. M.: Tuberculous pericarditis: A review of 17 recent cases. Tubercle (London), 48:160, 1967. Youmans, G. P., and Youmans, A. Curr. Top. Microbiol. Immure., 48:129, 1969.

in and growth rate. This tentative arrangement has been useful and widely accepted. (See Bacteriology in the article on Tuberculosis). More recently most of the known human pathogens have received tentative but widely accepted species designations, which will be employed herein. The relationship of these to the Runyon classification is as follows: M. Kansas and M. marinurn. Runyon Group I (photochromogens); M. scrofula-acetum Runyon  Group  II (Scotchwomen); Extracellular* (Beatty bacillus), M. alluvium, and. Xenophon* — Runyon Group III (non-pigmented species); and M.fortuitum — Runyon Group IV (rapid growers).

Cholera (Asiatic Cholera) Leighton E. Cluff

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