Miliary Tuberculosis Presenting Research Articles

Miliary Tuberculosis Presenting With Meningitis, Tuberculomas, Osteomyelitis, Psoas Abscesses, and Pulmonary Involvement

Miliary Tuberculosis Presenting With Meningitis, Tuberculomas, Osteomyelitis, Psoas Abscesses, and Pulmonary Involvement

Miliary Tuberculosis Presenting as Altered Mental Status

Miliary Tuberculosis Presenting as Altered Mental Status

Miliary Tuberculosis Presenting as Pyrexia of Unknown Origin in a Health Care Worker

Miliary Tuberculosis Presenting as Pyrexia of Unknown Origin in a Health Care Worker

The Onset of Miliary Tuberculosis Presenting after an Episode of Angina, Palpitations and Cardiac Stent Placement

The novel Coronavirus of 2019 (COVID-19) has dramatically reminded the world of the importance of noting pertinent travel history.

A case of miliary tuberculosis presenting as massive hepatosplenomegaly and fatal hepatic failure.

A case of miliary tuberculosis presenting as massive hepatosplenomegaly and fatal hepatic failure.

The onset of miliary tuberculosis presenting after an episode of angina, palpitations and cardiac stent placement

The onset of miliary tuberculosis presenting after an episode of angina, palpitations and cardiac stent placement

Miliary Tuberculosis Presenting as Pyrexia of Unknown Origin in Pregnancy

Miliary tuberculosis (TB) due to the widespread dissemination of Mycobacterium tuberculosis remains rare, occurring in less than 1-2% of cases, and is usually associated with risk factors including female gender, extremes of age, immunosuppressed states, poor socioeconomic status and alcoholism. Delay in diagnosis or treatment of TB has been associated with poor maternal and fetal outcomes such as anemia, preeclampsia, pneumonia, preterm labor, congenital infection and intra-uterine death. We described a case of miliary TB in pregnancy presenting as prolonged fever with a negative workup showing the challenges in diagnosing miliary TB antenatally, as manifestations can be non-specific and investigation results are inconclusive. This case emphasizes the importance of a multidisciplinary team, especially of obstetricians with expertise in high-risk pregnancies, infectious diseases, rheumatologists and neonatologists. J Clin Gynecol Obstet. 2019;8(4):114-117 doi: https://doi.org/10.14740/jcgo591

Miliary tuberculosis presenting as scrofula in a healthy man: a diagnostic challenge

Miliary tuberculosis presenting as scrofula in a healthy man: a diagnostic challenge

Miliary Tuberculosis Presenting as Pyrexia of Unknown Origin in Pregnancy

Miliary Tuberculosis Presenting as Pyrexia of Unknown Origin in Pregnancy

Miliary tuberculosis presenting as a choroidal mass and a tuberculosis screening review

Anti-tumor necrosis factor alpha (anti-TNF) therapy is a standard of care in the management of many inflammatory conditions. However, anti-TNF pharmaceuticals increases the risk of reactivating tuberculosis making screening for latent tuberculosis infection (LTBI) a requirement prior to initiating therapy. Case: A middle-aged male from China with a past medical history of LTBI and Crohn's disease, previously on infliximab, presented to the United States for a second opinion on his abdominal pain. He also reported new onset visual changes. Ophthalmology evaluation revealed a 4 cm choroid mass of his left eye and a CT scan of the abdomen showed diffuse lymphadenopathy and lesions in his liver, spleen, and lung. He was admitted for treatment of miliary tuberculosis. Discussion: Immunocompromised patients are a unique population that brings challenges to LTBI testing. Conclusion: Clinicians should know the most up to date screening tools for LTBI and diagnostic workup for active tuberculosis infection.

Corrigendum to “Miliary Tuberculosis Presenting with ARDS and Shock: A Case Report and Challenges in Current Management and Diagnosis”

[This corrects the article DOI: 10.1155/2017/9287021.].

Miliary Tuberculosis Presenting With Meningitis in a Patient Treated With Mycophenolate for Lupus Nephritis: Challenges in Diagnosis and Review of the Literature.

Tuberculosis is one of the top 10 causes of death worldwide according to the World Health Organization. Central nervous system involvement is usually the least common presentation of tuberculosis occurring in about 1% of all cases but yet can have very devastating outcomes. Lupus nephritis is one of the most common complications of systemic lupus erythematosus with up to two thirds of patients presenting with some degree of renal dysfunction. The mainstay of treatment is glucocorticoids; however, to sustain remission, steroid sparing agents such as cyclophosphamide, azathioprine and mycophenolate mofetil are used. Such patients, in addition to their baseline dysfunctional immune system, have a heightened risk of infections due to these drugs. In this article, we present a young woman who had recently been started on mycophenolate mofetil for control of class V lupus nephritis who presented with headaches, sinus pressure, and fevers. She had a protracted course of hospitalization as she failed to improve clinically and to respond to conventional therapy for acute bacterial sinusitis and meningitis. She was empirically started on antitubercular therapy 9 days after hospitalization. The diagnosis was not confirmed until day 18, the day results of cerebrospinal fluid acid-fast bacillus culture was reported. This case is reported to highlight the challenges in diagnosing Mycobacterium tuberculosis infection in an immunocompromised state and to demonstrate that its presentation can mimic numerous other conditions. Clinicians must maintain a high index of suspicion of Mycobacterium tuberculosis infection in such patients who present with nonspecific or unexplainable symptoms.

Lower gastrointestinal bleeding as a presentation of miliary tuberculosis

Lower gastrointestinal bleeding as a presentation of miliary tuberculosis

Neuro-Behcet's Syndrome with Miliary Tuberculosis Presenting with Features Mimicking Acute Tuberculous Meningitis

Neuro-Behcet's Syndrome with Miliary Tuberculosis Presenting with Features Mimicking Acute Tuberculous Meningitis

Miliary Tuberculosis Induced Acute Liver Failure.

Hepatobiliary tuberculosis is uncommon even in endemic countries. It is associated with a high mortality and is even diagnosed early in the disease course. Acute liver failure (ALF) caused by tuberculosis bacilli has been reported in only a few reports. All previous cases have been diagnosed by postmortem examination. Time to antituberculosis treatment is very critical. In case of suggestive findings on clinical and radiologic examination, antituberculosis treatment should be initiated immediately. Drug use can be a challenge in patients with ALF. However, as long as the other possible causes of ALF can be excluded and hepatotoxic drugs were avoided during the early course of treatment, such a highly fatal presentation of tuberculosis can be treated safely. Here, we report a case of acute liver failure as a presentation of miliary tuberculosis. He was treated successfully with antituberculosis treatment.

Ruxolitinib Associated Tuberculosis Presenting as a Neck Lump.

Tuberculosis is an opportunistic infection with protean clinical manifestations. We describe a case of Ruxolitinib induced miliary tuberculosis presenting as a neck lump. A 78-year-old female presented with a two-month history of right-sided neck lump associated with fever, night sweats, and significant weight loss. She had a past medical history that included myelofibrosis, being treated with Ruxolitinib. Examination demonstrated 4 × 4 cm right-sided cervical lymphadenopathy. A chest radiograph showed extensive shadowing in both lungs. CT scan demonstrated perilymphatic nodes in addition to the cervical mass. An ultrasound-guided biopsy of a cervical lymph node demonstrated confirmed Mycobacterium tuberculosis infection. It was hypothesized that use of Ruxolitinib through its selective inhibition of Janus-activated kinases 1 and 2 resulted in immunosuppression and miliary tuberculosis in this patient. The medication was stopped and a 12-month regime of antituberculosis therapy commenced. She remained well at one-year follow-up with resolution of lung involvement. Clinicians should consider tuberculosis as a differential diagnosis for patients presenting with a neck lump, particularly in those taking immunosuppressant medication such as Ruxolitinib. A multidisciplinary approach is needed to promptly treat the tuberculosis and consider discontinuation of Ruxolitinib.

Primary pulmonary miliary tuberculosis presenting as immune thrombocytopenia- a rare case report

Case report A 42 year old female patient presented with petechiae on palate, tongue and extremities, melena and also developed conjunctival hemorrhage, hemoptysis, occult blood in stool. She had a history of evening rise of temperature since one month, non-productive cough since one week. Physical examination revealed no organomegaly, no lymphadenopathy and detailed investigations were done. Chest radiograph showed fine nodular opacities throughout lung field but tuberculin test and early morning sputum AFB examination for three consecutive days was negative. Hb 9.6gm%, PCV28, TLC4100/cumm, platelets-32000/cumm, ESR 52mm in 1st hour and 94mm in 2nd hour. Ultrasound abdomen was normal, HIV ELISA, dengue antibodies was negative, ANA and RA was positive. Diagnosis of pulmonary miliary tuberculosis was considered and patient was given platelet transfusion, IV corticosteroids, and was on anti tubercular therapy for 6 months. The platelet count was normal within ten days, lung lesions resolved and no antibodies were detected after six months. There was no recurrence of TB or ITP and no complain of joint pains after a follow up of three years.

Atypical Presentation of Miliary Tuberculosis With Hepatic Involvement Early After Renal Transplantation

Atypical Presentation of Miliary Tuberculosis With Hepatic Involvement Early After Renal Transplantation

Miliary Tuberculosis Presenting With GI Bleed From Hepatic Artery Pseudoaneurysm Rupture in an HIV Infected Patient

SESSION TYPE: Infectious Disease Student/Resident Cases

Intestinal Tuberculosis in an HIV-Infected Patient With Advanced Immunosuppression

s e A homosexual man was admitted to our hospital with a 1-month history of fever, diarrhea, and anorexia. He as diagnosed with HIV infection 11 years earlier and since then, ad been treated with highly active antiretroviral therapy. On dmission, the patient was alert with a body temperature of 9.5°C. Laboratory tests on admission showed a low CD4 count 48 cells per L) and elevated C-reactive protein (13.88 mg/dL). Colonoscopy showed a few giant ulcers at the terminal ileum and a shallow ulcer at Bauhin’s valve (Figure A). A biopsy and aspiration of intestinal fluid from the lesions were then performed endoscopically. The biopsy specimen revealed numerous acid-fast bacilli on auramine staining (Figure B). Both biopsy and intestinal uid sample showed Mycobacterium tuberculosis with the polymerase hain reaction method. Computed tomography showed bilateral ulmonary miliary tuberculosis and a thickened ileum (Figure C). esults of acid-fast staining and polymerase chain reaction of the putum were positive. The acid-fast bacilli cultures of biopsy, ntestinal fluid, sputum, and blood were positive. Based on these ests, the final diagnosis was pulmonary tuberculosis, miliary tuerculosis, and intestinal tuberculosis. Treatment with oral isonizid, rifampicin, pyrazinamide, and ethambutol was started. After month of treatment, the patient’s clinical symptoms were much mproved, and colonoscopic appearance was changed to ulcer scar. There are various pathogens responsible for HIV-related diarhea,1 and it is difficult to predict the pathogen based on clinical features alone. Endoscopy not only is useful for obtaining an image, but it is also useful to biopsy the mucosal lesion and aspirate intestinal fluid.2 This diagnostic method was quite useful n this case because intestinal tuberculosis was not initially susected on macroscopic appearance alone. This is a rare case report ecause the diagnoses of intestinal, pulmonary, and miliary tuberulosis were reached owing to the examination of chronic diarrhea. Identical endoscopic findings, such as round, irregular-shaped, nd small ulcers have been reported in intestinal tuberculosis cases,3 but a giant deep ulcer is extremely rare. Cellular immunouppression may lead to the growth of M tuberculosis and the xpansion of the lesion, such as a giant, deep ulcer. Jones et al4 reported that extrapulmonary tuberculosis is more common in those with low CD4 cell counts in HIV patients. In this case, the patient, who had a low CD4 count (48 cells per L), showed pulmonary tuberculosis, miliary tuberculosis, and intestinal tuberculosis presenting as a giant deep ulcer. These manifestations of tuberculosis might be related to low CD4 cell counts.