Abstract
Problem statement: During the last years it is more than evident that the prevalence of pulmonary and extrapulmonary Tuberculosis (TB), mainly in western European countries, has risen significantly. The aetiology of this phenomenon is multifactorial. Miliary tuberculosis is a form of tuberculosis that is characterized by millet-like seeding of TB bacilli in the lung, as evidenced on chest radiography. Approach: A 17-year-old woman with headache, nausea-vomiting and fever of two months before. The patient's symptoms exacerbate and had weight that referred to the emergency department with severe headache and frequently vomiting. Bilateral coarse ceracel without wheezing. In primary CXR, diffuse reticulonodular two lungs with opened with pleural open angles. In thoracic HRCT images, diffuse micronodular lesions in throughout the lung Parenchyma, peribronchovascular thickening in parahilar areas and significant increases in the thickness of several upper lobe bronchus. In brain MRI, multiple micronodular lesions with probably miliary TB were reported. AFB of BAL sample was 1+ and cytology of BAL was negative for malignancy. HIV Ab, HBS Ag, HCV Ab and IgM HAV were negative. U/A, U/C B/C was normal. Conclusion: Results of BAL culture were positive for TB and Granulomatous inflammation, surrounded by mile lymphocytic infiltrate, with central necrosis, suggestive of TB were reported in endobronchial biopsy.
Highlights
During the last years it is more than evident that the prevalence of pulmonary and extrapulmonary Tuberculosis (TB), mainly in western European countries, has risen significantly
Miliary tuberculosis is a form of tuberculosis that is characterized by millet-like seeding of TB bacilli in the lung, as evidenced on chest radiography (Moon, 1997)
Results of BAL culture were positive for TB and Granulomatous inflammation, surrounded by mile lymphocytic infiltrate, with central necrosis, suggestive of TB were reported in endobronchial biopsy
Summary
During the last years it is more than evident that the prevalence of pulmonary and extrapulmonary Tuberculosis (TB), mainly in western European countries, has risen significantly. Miliary TB may occur in an individual organ (very rare, 90%), including brain, lungs, liver and spleen. It is a complication of 1-3% of all TB cases (Sharma et al, 2005). Fourth day of anti-TB treatment, the patient suffered abdominal pain, nausea and frequent that in physical examination, epigastric and RUG tenderness was found and significant increase was observed in liver enzymes that in left day , increased ALT up to 1200 and AST up to 386
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