A young 20-year-old woman with an atypical tuberculin reaction.

A 20-year-old female patient presented with fever and swelling in the neck accompanied by anorexia and weight loss. The clinical examination revealed a febrile patient with diffuse cervical lymphadenopathy. Routine investigations were negative. A 5TU (tuberculin units) tuberculin skin test (Mantoux test) was positive with an induration of 52 × 40 mm after 72 h with central blistering, exudation and ulceration. Aspiration cytology from the cervical lymph node revealed the presence of caseating granulomas. The patient responded completely to antitubrecular therapy. Enhanced-tuberculin reactions may occur on occasion in tuberculosis.