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Table 1 Investigations and findings

From: Scrofuloderma with disseminated tuberculosis in an Ethiopian child: a case report

Serial number 

Investigations

Results or findings

1

Complete blood count

WBC 13.9 × 103

Red blood cell count 4.4 × 103

Platelet count 278 × 103

Hematocrit 10 g/dl

2

Urinalysis

pH 6

Specific gravity 1.020

Negative for ketone and glucose

WBC 2–5/HPF

Negative for chemical tests (leukocyte esterase, nitrite, urobilinogen, protein)

3

Liver function tests

AST/SGOT (aspartate transaminases) 92U/L

SGPT/ALT (alanine aminotransferase) 40U/L

ALP (alkaline phosphatase) 100IU/L

4

Renal function test

Creatinine 0.5mg/dl

5

HIV

Negative antibody test

4

Erythrocyte sedimentation rate in first hour

65 mm/hr

2

Cerebrospinal fluid analysis

105 cells (65 lymphocytes)

No organism on Gram stain and acid-fast bacilli stain

3

Chest x-ray

Right upper and middle lobe ill-defined airspace opacity

4

Skin discharge analysis

Gram-positive diplococci in chain on Gram stain, Mycobacterium tuberculosis on Xpert MTB/RIF assay

5

Fine-needle aspiration cytology

Only caseous necrosis, no granuloma, and smears from ulcerated lesions show mixed inflammatory cells, predominantly polymorphs

6

Skin biopsy

Tuberculous scrofuloderma: with section showing mature squamous cell-lined skin tissue composed of epithelioid cell granuloma, multinucleated giant cells, caseous necrosis, and mixed inflammatory cells

7

Brain computed tomography

Multiple precontrast hyperdense randomly distributed supra- and infratentorial lesions with mild perilesional edema. Rim enhancement on postcontrast image (caseating granulomas) on some lesions and solid pattern of enhancement (noncaseating granulomas) evident on others. Dense basal cistern exudate seen on precontrast images with avid postcontrast basal leptomeningeal enhancement. Severe bilateral lateral, third- and fourth-ventricle dilation was noted.

  1. Abbreviations: HIV Human immunodeficiency virus, HPF High-power field, Xpert MTB/RIF Automated real-time nucleic acid amplification technology used for rapid and simultaneous detection of tuberculosis and rifampicin resistance, WBC White blood cell