[Tuberculosis of the placenta in a women with miliary tuberculosis; birth of a normal infant, unharmed by the tuberculous infection; value of the placental barrier].
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Female↗
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Results for “Tuberculosis, Miliary”
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[Miliary tuberculosis with atypical radiographic findings after aorto-coronary bypass surgery].
Dry cough and exertional dyspnea developed in a 78-year-old man after aorto-coronary bypass surgery for angina pectoris. Chest X-ray films showed small nodular shadows in the upper and middle fields of both lungs. The patient's condition was exacerbated despite treatment with antibiotics. Chest high-resolution computed tomography disclosed small nodular and reticulo-linear shadows predominantly in the interlobular septa and bronchovascular bundles. Transbronchial lung biopsy specimens revealed micro-granulomas with necrosis, suggesting miliary tuberculosis. Antituberculosis drugs were started and the patient's symptoms and radiographic findings gradually resolved. Cases of cellular immunosuppression have beer reported in patients following open-heart surgery that utilized antifical heart and lung apparatus. Such procedures, together with hemodialysis, deserve consideration as potential risk factors for miliary tuberculosis.
Aged↗
[Portal and splenic veins thrombosis reveling a miliary tuberculosis of the liver].
The etiologies of the portal vein trombosis are dominated by the neoplasic forms with hepatocellular carcinoma; we report a rare case of portal and splenic veins thrombosis revealing a liver military tuberculosis occuring in a HIV 1 infected patient. A 42 years old senegalese woman with no personal or family history of thrombosis was admitted for abdominal upper right quadran, and epigastric pain, with fever and important weight loss. Ultrasound identified endoluminal echogenic images in the portal and splenic veins. There were no lymph nodes or liver tumor. Evaluations of proteins C and S were normal and there was no anticardiolipin antibody. In searching the aetiology of the thrombosis, a liver biopsy was performed, and showed a miliary tuberculosis. an HIV 1 infection was later on diagnosed. The antituberculosis treatment associated with heparine therapy was successful, the thrombosis resolved entirely. This portal and splenic veins thromboses occuring on a miliary tuberculosis of the liver seems to be an exceptional situation. We did not found in the literature a similar case.lt points out the interset of liver biopsy in searching the aetiology and the early heparine therapy set up
Adult↗
[A case of miliary tuberculosis and chest wall cold tuberculous abscess with contents draining into the epidural space].
A 37-year-old man was admitted because of miliary tuberculosis. However, his fever and general condition did not improve with chemotherapy. Six months later, paraplegia occurred following sudden radicular back pain without any alteration of segmental sensation. There were no abnormal findings on X-ray films of the thoracic and lumbar vertebrae. Examination by magnetic resonance imaging revealed that the contents of a cold tuberculous abscess in the right chest wall had drained into the epidural space through the intervertebral foramen. Drainage of the chest wall abscess and laminectomy were performed. Further investigation showed that this case did not belong to the usual type of atypical spinal tuberculosis reported previously.
Abscess↗
Auditory disorder in central nervous system miliary tuberculosis: case report.
We evaluated a 28-year-old female with a unilateral hearing loss of unusual pathogenesis, that of central nervous system miliary tuberculosis. Audiologic and otologic findings were consistent with left retrocochlear disorder, characterized by a profound hearing sensitivity loss, absent acoustic reflexes, normal otoacoustic emissions, and the presence of only wave I of the auditory brainstem response. Imaging studies revealed the presence of multiple punctate lesions, one of which was extra-axial and located at the left cerebellopontine angle. The pattern of audiometric test results, particularly the combination of normal otoacoustic emissions and profound hearing sensitivity loss, contributed importantly to the investigative sequence leading to the final diagnosis.
Acoustic Stimulation↗
Miliary tuberculosis presenting as infection of a pacemaker pulse-generator pocket.
A seventy year old woman had a permanent VVI pacemaker inserted in 1983 for complete heart block and presented ten years later with purulent discharge from the generator pocket. During a prolonged pyrexial illness, she developed renal and respiratory failure and her illness was complicated by recurrent ventricular fibrillation. The patient died on her 31st hospital day. Subsequent histological and microbiological investigation revealed widespread miliary tuberculosis which included involvement of myocardial tissue, great vessels and the pacemaker pocket. To our knowledge, this is the first reported occurrence of miliary tuberculosis involving a permanent pacemaker system. Furthermore, the granulomatous myocarditis which occurred as part of the miliary picture is a rare occurrence and possibly explains the recurrent ventricular fibrillation.
Aged↗
Discrepancy between gallium-67 citrate scans and chest X-rays in patients with miliary tuberculosis.
Two patients were admitted to our hospital with a diagnosis of miliary tuberculosis (TB). Gallium-67 citrate (Ga) scans and chest X-rays were used to localize the TB lesions. One case showed normal chest X-ray with significant gallium uptake in the lung while the other showed diffuse interstitial infiltrations of both lungs in chest X-ray with negative result in gallium scan. We suggest that the combination of Ga scans and chest X-rays might be indicated to avoid the discrepancy between the two images and missing early diagnosis of miliary TB.
Adult↗
Miliary tuberculosis in two infants after nursery exposure: epidemiologic, clinical, and laboratory findings.
Two infants born 4 days apart, and cared for in the same nursery, developed miliary tuberculosis at 2.5 and 5.5 months of age, respectively. A search for a source case among household contacts failed to reveal anyone with active tuberculosis. An epidemiologic study of nursery personnel revealed a nurse's aide with cavitary tuberculosis. Examination of 1,647 infants (98.9 per cent of all infants cared for in the nursery during the 10.5-month period preceding the discovery of the source case) failed to reveal any other infected children. Recommendations are made for tuberculosis control programs among nursery personnel that should be carefully and persistently followed.
Adult↗
[Miliary tuberculosis and silicosis with predominantly cerebral symptoms].
HISTORY AND CLINICAL FINDINGS: About 10 weeks before admission to hospital a 73-year-old woman developed a fever of up to 40 degrees C for three days. She then had subfebrile temperature for several weeks with some rises to 39 degrees C. She was known to have type II a diabetes mellitus and pulmonary silicosis, having worked in a porcelain and ceramic factory for many years. Before admission her cerebral functions were rapidly deteriorating, especially short-term memory. This was followed by increasing paraplegia of the legs with inability to walk. She finally had urinary and faecal incontinence and swallowing difficulties with tendency to aspiration, which necessitated hospitalisation. INVESTIGATIONS: Both lactate dehydrogenase (339 U/l) and C-reactive protein (112 mg/l) were elevated; the platelet count was low (73000/microliters). Cerebrospinal fluid was unremarkable, as was computed tomography of the skull. But magnetic resonance imaging revealed multiple spotty lesions with low contrast-medium uptake throughout the brain, pointing to a disseminated bacterial or mycotic infection. 3 days later the chest-ray showed small nodular soft shadows in the lungs, and lung functions had decreased. Mycobacteria were found in the urine and liver biopsy showed granulomatous hepatitis, establishing the diagnosis of miliary tuberculosis in the presence of silicosis. TREATMENT AND COURSE: Tuberculostatic treatment was instituted with four drugs (pyrazinamide, ethambutol, isoniazid and streptomycin. After 6 weeks the patient was again able to walk and continent of urine during the day. All cerebral functions gradually improved. CONCLUSION: Miliary tuberculosis should be included in the differential diagnosis of ill-defined feverish disease, especially in the elderly.
Aged↗
Retrospective survey of the management of miliary tuberculosis in South and West Wales, 1976-8.
In a survey of 1000 patients with tuberculosis 28 were found to have miliary disease. Half of these patients were over 60 years old. Anorexia and weight loss were present in 19 (70%) and pyrexia in 17 (63%). A factor predisposing to tuberculosis or a history of recent contact was found in 12 (43%), and 21 (75%) had positive cultures. Seventeen (61%) had classical miliary shadowing while four (14%) had cryptic miliary tuberculosis with no radiological evidence of tuberculosis. The remaining seven patients (25%) had radiological changes consistent with pulmonary tuberculosis, but no miliary shadows. Of those who completed chemotherapy, only five (42%) received 18 months' treatment. Nine patients (32%) died from their miliary tuberculosis. Failure to consider the diagnosis, leading to a delay in starting chemotherapy, appeared to be a major problem.
Adolescent↗
A patient with suspected sarcoidosis died from miliary tuberculosis.
In Western Europe, awareness of tuberculous lymphadenitis (TLA) has declined. This report describes a patient who had suspected sarcoidosis for 3.5 y, who eventually died from miliary tuberculosis due to delay in diagnosis. The report includes a discussion of the differential diagnosis of TLA and sarcoidosis.
Adult↗
[A case of miliary tuberculosis complicated by acute respiratory failure after bronchofiberscopy].
A 79-year-old man presented with persistent nonproductive cough and high fever. The chest radiograph showed bilateral miliary shadows. We performed bronchoalveolar lavage and transbronchial lung biopsy to assist diagnosis. Severe dyspnea developed after the bronchofiberscopy, when the chest radiograph revealed bilateral ground-glass shadows and the oxygen saturation in the room air fell to 60%. It was suspected that the patient had acute respiratory distress syndrome, so that methylprednisolone was given intravenously at a dose of 250 mg daily for 3 days, which resulted in a reduction in ground glass shadows and an improvement in oxygen saturation. We diagnosed miliary tuberculosis because the transbronchial lung biopsy specimen showed caseous granuloma and the PCR test for Mycobacterium tuberculosis in the bronchoalveolar lavage fluid was positive. The patient was cured with antituberculosis chemotherapy.
Aged↗
Miliary tuberculosis causing pancytopenia. A report of 2 cases.
Tuberculosis is a common disease in South Africa, but the diagnosis may be difficult when it presents in the miliary form. Two cases of miliary tuberculosis with pancytopenia are described.
Female↗
Miliary tuberculosis presenting as adult respiratory distress syndrome.
We report the history of a 27-year-old Caucasian girl who died of adult respiratory distress syndrome secondary to miliary tuberculosis (MTB), after treatment with antibiotics to which the organism was sensitive, and a long period of ventilation. This case emphasises the importance of considering MTB as the cause of respiratory failure when another aetiology is not apparent.
Adult↗
[Hemophagocytic syndrome due to miliary tuberculosis in the course of aplastic anemia].
We report a 63 year-old female with aplastic anemia (AA) who was complicated with hemophagocytic syndrome induced by systemic miliary tuberculosis. Two years before admission to our hospital, she was diagnosed as AA and had been treated with granulocyte colony-stimulating factor, erythropoietin and methenolone acetate. In May, 1996, She was transferred to our hospital because of high fever and exacervation of pancytopenia. She showed severe pancytopenia, and an increase in macrophages showing remarkable erythrophagocytosis and decrease in hemopoietic cells in the bone marrow. In initial examination, high titer of IgM antibody to herpes simplex virus type I was identified and methylprednisolone pulse therapy was started under the diagnosis of virus associated hemophagocytic syndrome. Ten days later, however, she died for intestinal hemorrhage followed by multiorgan failure. In autopsy, multiple epitheloid cell granulomas with acid-fast bacilli were found in bone marrow, lungs, liver, spleen and kidneys.
Anemia, Aplastic↗
[Signs of miliary tuberculosis: which diagnostic tests and when to treat?].
Three patients, men aged 21, 57 and 53 years, presented with variable non-specific symptoms such as general malaise, weight loss, elevated temperature, abdominal pain, cough, pulmonary crepitations and elevated liver enzymes. Diffuse fine nodular infiltration was seen on chest radiography in the last two cases. The first patient refused to be tentatively treated with tuberculostatics and died. Mycobacterium tuberculosis complex grew on Löwenstein medium a week later. The two other patients received tuberculostatic treatment. The second patient recovered, while the third patient suffered a cerebrovascular accident on top of emaciation and respiratory insufficiency and died. In the Netherlands, currently more than one hundred patients with tuberculosis disease die each year. The disease is mostly seen in people from the high-risk groups for tuberculosis such as asylum seekers and immigrants. Even after extensive diagnostic procedures it can be difficult to obtain rapid bacteriological confirmation. When miliary tuberculosis is suspected it is important to carry out the complete range of tests (Ziehl Neelsen microscopy, PCR, Löwenstein cultivation) and to start therapy immediately and not to await the results of the diagnostic tests. However, in many cases this may still be too late, with an estimated mortality of 20%.
Adult↗
[A case of hemophagocytic syndrome associated with miliary tuberculosis].
We reported a case of a 76-year-female with hemophagocytic syndrome caused by military tuberculosis. The patients had complained high fever over 38.0 degrees C and anorexia. Her chest X-ray and computed tomography revealed disseminated miliary shadows in both lung fields. Laboratory examinations revealed anemia, thrombocytopenia and liver dysfunction. Bonemarrow aspirate revealed tuberculous granulomas and tubercle bacilli by acid-fast stains, and hemophagocytosis by macrophages. We diagnosed as miliary tuberculosis and tuberculosis-associated hemophagocytic syndrome, and started antituberculous and steroid therapy. After these therapy, fever, laboratory examinations dramatically improved. In this case, serum IL-18, sICAM-1, sVCAM-1 were elevated. These cytokines and adhesion molecules were reported to elevate in both hemophagocytic syndrome and tuberculosis correlating with disease activity. We conclude that IL-18, sICAM-1, sVCAM-1 may play important roles in pathogenesis of tuberculosis associated hemophagocytic syndrome.
Aged↗
An autopsy case of miliary tuberculosis in a young adult.
A 23-year-old woman who had worked as a hostess at a nightclub was found dead in her house. The cause of death was diagnosed as miliary tuberculosis from the findings of medico-legal autopsy. Recently, tuberculosis (TB) has re-emerged as a health problem due to recurrence in the aged, and infections among health care workers and young adults like the present case. Currently, the common source of TB transmission is recurrence in the aged, but global migration, difficulty to achieve permanent immunity by BCG vaccination, immunodeficiency such as HIV infection, and drug abuse and/or sexual intercourse are also thought to be associated with tuberculosis in young adults. Forensic pathologists should be aware of such connections with TB, and should take care not to become mediators of TB infections.
Adult↗