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PubMed2004

Miliary tuberculosis presenting as acute respiratory distress syndrome, septic shock, DIC, and multiorgan failure.

A 48-year-old Hispanic man developed acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC), fulminant hepatic failure, renal dysfunction, pancytopenia and septic shock, and died on his fourth day of hospitalization. The postmortem examination revealed caseating and non-caseating granulomas in all sampled organs. Antemortem sputum and postmortem pulmonary tissue cultures were positive for Mycobacterium tuberculosis. Miliary tuberculosis (TB) was diagnosed. Factors associated with mortality include delayed diagnosis/therapy and presence of ARDS, DIC, septic shock, and multiorgan failure.

Acute Disease↗
PubMed1980

Miliary tuberculosis following ureteral catheterization.

In a patient with undiagnosed right renal tuberculosis miliary spread to both lungs developed following ureteral catheterization. Mycobacteremia with miliary metastatic foci should be considered as a complication of urinary tract instrumentation in the presence of renal tuberculosis.

Female↗
PubMed2000

Unusual cutaneous manifestations of miliary tuberculosis.

Cutaneous manifestations of miliary tuberculosis are extremely rare. We describe a 62-year-old woman with leukopenia who developed infiltrated dermal-hypodermal and ulcerative cutaneous lesions during the course of miliary tuberculosis. Miliary tuberculosis was diagnosed when Mycobacterium tuberculosis bacilli were isolated by cultures of the bronchoalveolar lavage fluid and blood and when acid-fast bacilli were detected on histopathologic examination of hepatic, pulmonary, and cutaneous biopsy specimens. With the increasing incidence of immunocompromised patients, unusual presentations of tuberculosis may be observed more often. Acute miliary tuberculosis of the skin is an exceptional manifestation that is due to acute hematogenous dissemination of M. tuberculosis to the skin. We describe a patient who had unusual cutaneous manifestations of miliary tuberculosis.

Female↗
PubMedDate not supplied

Intermittent chemotherapy for miliary tuberculosis in children.

Miliary tuberculosis is a severe manifestation of tuberculosis. Six children aged between two months and 10 years with the diagnosis of miliary tuberculosis were treated with intermittent antituberculous therapy for six, nine or 12 months. All the patients showed clearance of both clinical and radiological symptoms; there was no drug toxicity or resistance and no relapses were seen in the follow-up period ranging from nine months to nine years. Intermittent therapy is safe and effective in miliary tuberculosis and it may be an alternative therapy because of its minimal toxicity and lower cost.

Antitubercular Agents↗
PubMed1990

[A case of miliary tuberculosis with cutaneous lesion].

Miliary tuberculosis associated with cutaneous lesion has been rarely reported. We report a case of miliary tuberculosis in whom the cutaneous lesion was confirmed as tuberculosis by skin biopsy and bacterial examination. A 46-year-old man was admitted because of cough, fever, sore throat and abnormal shadow on the chest X-ray. Physical examination revealed an emaciated man with two ulcerous lesions overlying yellowed crust on the chest wall and fine crackles on the left side of the lung. Laboratory workup revealed a white blood cell count of 10,000 with 15% lymphocytes and positive CRP. Chest X-ray film showed the infiltration with cavity formation in left upper lung field and nodular dissemination. His tuberculin reaction was negative on admission. Sputum, urine and secrete from cutaneous lesion were positive for the acid-fast bacilli and the culture grew Mycobacterium tuberculosis. Examination of the skin biopsy specimen and bone marrow aspiration showed Langhans giant cells around necrotic lesion; therefore the diagnosis of miliary tuberculosis was made. After an initiation of antituberculosis therapy with combined regimen composed of streptomycin (SM), isoniazid (INH), ethambutol (EB) and rifampicin (RFP), this patient improved significantly. Although the case report of miliary tuberculosis tends to increase recently, the report of cutaneous lesion is relatively rare in association with miliary tuberculosis. We discussed this subject with reference to the literatures.

Biopsy↗
PubMed2004

Acute respiratory distress syndrome due to miliary tuberculosis in a patient with rheumatoid arthritis under corticosteroid therapy.

We report the case of a 65-year-old woman with rheumatoid arthritis (RA) under corticosteroid therapy who presented with high fever and dyspnea and who, within 48 h, developed acute respiratory distress syndrome (ARDS) due to Mycobacterium tuberculosis (MTB). Miliary tuberculosis is a rare cause of ARDS; however, because of its ominous outcome, it should be included in the differential diagnosis of immunocompromised patients with rapidly worsening respiratory discomfort. A brief review of miliary tuberculosis as a cause of ARDS is presented.

Journal Article↗
PubMed1987

The significance of pancytopenia in miliary tuberculosis.

Patients with miliary tuberculosis accompanied by a pancytopenia rarely survive their disease. If the peripheral blood picture does recover it has been taken as an indication that there is no underlying haematological disease, and so re-examination of the bone marrow is not performed. A case is described where resolution of the pancytopenia occurred but a persisting haematological disease remained. Aspects of haematological disease associated with tuberculosis are discussed.

Aged↗