SINCE tuberculosis is now uncommon in the United States,1 the diagnostic index of suspicion may be low when unusual modes of presentation are encountered. We describe here an unusual case of nonpulmonary tuberculous infection as a reminder that this disease continues to appear in North America.
Report of a Case
A 47-year-old man, seen in April 1979, stated that open wounds had developed over the inner aspect of both elbows in September 1978. He worked in a meatprocessing plant, handling meat that was being processed in brine and other liquids. He frequently had to work before a high wooden table that was always wet; while engaged in this activity, he repeatedly rubbed the inside of the elbows, eventually leading to the appearance of an ulceration at the inner aspect of each elbow. He had been treated with antibiotics, but his wounds had failed to heal, and in fact had
Shea JM. Bilateral Tuberculous Osteomyelitis of Medial Humeral Condyles: Infection Secondary to Cutaneous Inoculation. JAMA. 1982;247(6):821–822. doi:10.1001/jama.1982.03320310069038
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