Autopsy findings of miliary tuberculosis in a renal transplant recipient

Abstract

Miliary tuberculosis is a lethal form of disseminated tuberculosis (TB), deriving its name from the millet-seed-sized granulomas in multiple organs. As TB still remains a leading cause of morbidity and mortality in India, its disseminated forms need to be diagnosed early to ensure more aggressive treatment at the earliest possible time. However, a considerable number of cases are missed ante-mortem. We discuss the case of a 32-year-old immunocompromised, non-HIV patient with an ante-mortem diagnosis of pulmonary TB. However, multiple organ involvement by Mycobacterium tuberculosis was demonstrated on autopsy. This case highlights the role of autopsy as a research and learning tool, and prudential clinico-pathologic correlation, which will improve clinical outcomes in the future.

Stance of pathology residents on declining number of autopsies

“…All the autopsy case reports published in A&CR journal highlight the educational value of the autopsies. Only within last year fascinating autopsy cases such as coronary amyloidosis, 4 disseminated aspergillosis, 5 gastrointestinal cytomegalovirus disease, 6 Morquio syndrome associated with gastric adenocarcinoma, 7 mycotic aneurysm with aortoduodenal fistula, 8 miliary tuberculosis in a renal transplant recipient, 9 disseminated toxoplasmosis diagnosed at autopsy, 10 Eisenmenger syndrome, 11 holoprosencephaly, 12 bone marrow necrosis and fat embolism syndrome in a patient with hemoglobinopathy, 13 pancreatic hamartoma in a premature Trisomy 18 female, 14 and intravascular large B-cell lymphoma 15 were published in A&CR. Moreover, pediatric autopsies usually reveal an undiagnosed entity and may highlight familial disorders which can help parents to plan future pregnancies accordingly.…”

One Year with Autopsy and Case Reports: An Immense Educational Experience

“…Autopsy cases section of the journal focuses of detailed autopsy findings of rare and unusual causes of death. Thorough and intrigue discussion about a number of unusual causes of death including coronary amyloidosis, 10 disseminated aspergillosis, 11 gastrointestinal cytomegalovirus disease, 12 Morquio syndrome associated with gastric adenocarcinoma, 13 mycotic aneurysm with aortoduodenal fistula, 14 miliary tuberculosis in a renal transplant recipient, 15 disseminated toxoplasmosis diagnosed at autopsy 16 and thymic teratoma causing non-immune hydrops fetalis, 17 can be found in this section. Again, these are just a few examples from a long list of cases available in the archives.…”