A rare case of polyarteritis nodosa associated with nontuber
Clinicians should be aware that cutaneous PAN can present with significant extracutaneous and constitutional symptoms which make it hard to differentiate from systemic PAN. The condition can also rarely be associated with NTM infections.

A 49‐year‐old Chinese woman with a history of treated pulmonary tuberculosis in 2005 presented in June 2013 with a two‐month history of productive cough and weight loss. On examination, she was cachectic with left lung basal crackles audible on auscultation. Computed tomographic (CT) scan of the thorax revealed lingual consolidation and prominent hilar lymph nodes.

Bronchoscopic examination of the lung tissues was unremarkable. Acid fast bacilli cultures of the sputum and bronchoalveolar lavage specimens were positive for Mycobacterium fortuitum and Mycobacterium abscessus. She was treated with oral clarithromycin, intravenous amikacin, and cefotaxime based on the antibiotic susceptibility testing, leading to the resolution of respiratory symptoms within 3 weeks.

In August 2013, she developed a persistent myalgia, paresthesia on her distal upper limbs and sustained a weight loss of 4kg over 4 weeks. She did not have fever, chills, or rigors. On examination, several tender, erythematous subcutaneous nodules were present on her right forearm and hand.

Source: Wiley online library

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