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At least 109 records · Page 6Linked to original sources
PubMed2001

Spontaneous pneumothorax: a rare complication of miliary tuberculosis.

Pneumothorax is a rare complication of miliary tuberculosis. In this report, a 25-year old patient developing pneumothorax while on the treatment for miliary tuberculosis treatment is presented and the related literature has been reviewed. Pneumothorax, although rare, should be considered when a patient with miliary tuberculosis develops a sudden, severe pain on either side of the chest with breathlessness. The treatment should be tailored according to the size of pneumothorax either pleural drainage through chest tube or needle aspiration. Meanwhile, antituberculous treatment should be continued without interruption.

Adult↗
PubMed2005

Miliary tuberculosis: new insights into an old disease.

Miliary tuberculosis is a potentially lethal form of tuberculosis resulting from massive lymphohaematogeneous dissemination of Mycobacterium tuberculosis bacilli. The emergence of the HIV/AIDS pandemic and widespread use of immunosuppressive drugs has changed the epidemiology of miliary tuberculosis. Impaired cell-mediated immunity underlies the disease's development. Clinical manifestations are non-specific and typical chest radiographic findings may not be seen until late in the course of the disease. Atypical presentations--eg, cryptic miliary tuberculosis and acute respiratory distress syndrome--often delay the diagnosis. Several laboratory abnormalities with prognostic and therapeutic implications have been described, including pulmonary function and gas exchange impairment. Isolation of M tuberculosis from sputum, body fluids, or biopsy specimens, application of molecular methods such as PCR, and histopathological examination of tissue biopsy specimens are useful for the confirmation of diagnosis. Although response to first-line antituberculosis drugs is good, evidence regarding optimum duration of treatment is lacking and the role of adjunctive corticosteroid treatment is unclear.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Miliary tuberculosis].

Seventy-four cases of miliary tuberculosis were studied retrospectively. Most common symptoms and findings were fever (97.3%), elevated serum alkaline phosphatase (67.6%), and nodular shadows in the chest X-ray films (98.6%). The other findings were enlarged mediastinal lymph node (17.6%), lung cavities (23.0%), consolidation (35.1%), and pleural effusion (27.0%). Sputum cultures and urine cultures were positive for Mycobacterium tuberculosis in 76.8% and 58.6% respectively. Biopsies were positive for bone marrow aspiration (61.5%), lymph node biopsies (83.3%), liver biopsies (100%), and lung biopsies (100%). Though antituberculosis therapy was successful in most of the patients, seven patients died of miliary tuberculosis, of whom four developed adult respiratory distress syndrome.

Adult↗
PubMed1986

Cryptic miliary tuberculosis.

Fifteen patients with cryptic miliary tuberculosis seen over a six-year period in a large teaching hospital were reviewed. This form of tuberculosis tended to be difficult to diagnose and was most common in older people and those with underlying diseases such as malignancy or blood dyscrasias. Bacteriological investigation was of the little help in diagnosis while bone marrow and liver biopsies were more useful. The diagnosis was made during life in only seven (47 per cent) of the 15 cases, and the overall mortality was 80 per cent. Tuberculosis should be considered in all cases of pyrexia of unknown origin, and investigations performed to establish or exclude the diagnosis. A prompt and adequate therapeutic trial with antituberculous treatment even in the absence of definite evidence of tuberculosis can be life-saving.

Adolescent↗
PubMedDate not supplied

Acute respiratory distress syndrome (ARDS) in miliary tuberculosis: a twelve year experience.

Miliary tuberculosis [MTB] is an uncommon but important treatable cause of acute respiratory distress syndrome [ARDS]. In this communication, six patients with MTB who developed ARDS in the course of their illness are described. The difficulties encountered in diagnosing MTB as a primary cause of ARDS are highlighted. The pathogenetic mechanisms of ARDS in MTB are briefly reviewed.

Adolescent↗
PubMed1996

Cutaneous miliary tuberculosis in the AIDS era: case report and review.

Tuberculosis with extrapulmonary manifestations is common in patients with AIDS. The skin is a site of dissemination that has often been overlooked. Historically, cutaneous miliary tuberculosis, also known as tuberculosis cutis miliaris disseminata, was noted to be a rare entity in adults; however, over the past 5 years, five cases of cutaneous miliary tuberculosis in human immunodeficiency virus (HIV)-seropositive individuals have been reported. We present the sixth such case and review the medical literature on cutaneous miliary tuberculosis in adults both before and during the AIDS era. The incidence of tuberculosis cutis miliaris disseminata in HIV-seropositive adults is likely higher than the incidence among the HIV-seronegative population that has been suggested in the historical literature. Its appearance can be quite nondescript; a high index of suspicion must be maintained, particularly for those patients with a CD4 cell count of < 200/mm3, to achieve the proper diagnosis and initiate appropriate therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1998

[Clinical review of 74 cases with miliary tuberculosis].

Seventy-four cases of miliary tuberculosis were studied retrospectively. The mean age of the patients was 45.3 years. Twenty-two patients suffered from another underlying diseases. Six were infected with human immunodeficiency virus. Twelve had been treated with corticosteroids. Fever was present in 97.3 per cent of patients. Elevation of serum alkaline phosphatase was found in 67.6 per cent of cases. The skin reaction to tuberculin was positive in 61.2 per cent. Nodular shadows were found in the chest X-ray in 98.6 per cent of cases. The nodules were smaller than 2 mm in diameter in 52.7 per cent of cases. Other findings were enlargement of mediastinal lymph node (17.6%), cavities (23.0%), pleural effusion (27.0%), and consolidation (35.1%). Sputum cultures and urine cultures were positive for Mycobacterium tuberculosis in 76.8 per cent and 58.6 per cent of cases respectively. The diagnosis was confirmed by histopathological findings in some cases. The rate of positive biopsies was 61.5 per cent by bone marrow aspiration, 83.3 per cent by lymph node biopsy, 100 per cent by liver and lung biopsy. Antituberculosis therapy was successful in most of the patients. Seven patients died of miliary tuberculosis, 4 of them had adult respiratory distress syndrome.

Adolescent↗