Unusual Presentation of a Common Disease: Disseminated Tuberculosis in an Immunocompetent Patient

Seif, Fadi; Armitage, Keith B.; Petrozzi, Mariana C.

doi:10.1016/j.amjmed.2010.01.021

Cited by 8 publications

(8 citation statements)

References 5 publications

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“…[3] It is usually severe, including multiorgan system failure, septic shock, and acute respiratory distress syndrome (ARDS). [4] Hence, miliary TB should always be considered in patients with ARDS of unknown causative factor, particularly if risk factors are present. The subacute or chronic manifestations of miliary TB are more usual than acute disease, and patients may exhibit failure to thrive, fever of unknown origin, night sweats, or dysfunction of one or more organ systems.…”

Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis with splenic involvement in an immunocompetent host: a rare entity

Ghewade¹,

Sharma²,

Chaudhari³

et al. 2016

Int J Med Sci Public Health

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Disseminated tuberculosis with liver and spleen involvement in an immunocompetent host is a rare entity today, not frequently diagnosed and reported. It is an unusual but possibly fatal form of tuberculosis observed largely in immunecompromised patients. Here, we report a case of a 22-year old immunocompetent woman who presented with multiple nodular opacities on chest X-ray. After investigations, she was diagnosed as a case of disseminated tuberculosis involving lungs, liver, abdominal lymph nodes, and spleen and responded well to antitubercular therapy.

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Section: Discussionmentioning

confidence: 99%

Disseminated tuberculosis with splenic involvement in an immunocompetent host: a rare entity

Ghewade¹,

Sharma²,

Chaudhari³

et al. 2016

Int J Med Sci Public Health

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“…Genetic defect in the interleukin -12 pathway or of gamma -interferon defect has been reported as predisposing factor for disseminated tuberculosis [2]. One should have a high index of suspicion for disseminated Mycobacterium tuberculosis in patients at risk, since these cases are potentially fatal and they are associated with high mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Immunocompetent host presenting with disseminated tuberculosis is uncommon [1,2]. Recognition of disseminated tuberculosis in countries with low endemic rates, especially in immigrant patients requires a high index of suspicion as they can be very challenging and potentially fatal.…”

Section: Introductionmentioning

confidence: 99%

Disseminated tuberculosis in an immunocompetent patient

et al. 2014

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AbstractA 53-year-old immigrant male patient presented with left scrotal swelling with a draining ulcer on the left hemiscrotum. Patient had intentional weight loss, fever and night sweats, cough, headaches, confusion and difficulty with ambulation. Imaging studies revealed innumerable pulmonary nodules, leptomeningeal enhancement of the brain and bilateral epididymo-orchitis. Acid fast bacilli (AFB) smear was positive from the surgical specimen of bilateral epididymis and left testes. Cerebrospinal fluid (CSF) analysis revealed neutrophilic predominant pleocytosis with low glucose and elevated protein. Polymerase chain reaction (PCR) test performed on the CSF and AFB smear of epididymis was positive for Mycobacterium tuberculosis. Though the CSF and sputum AFB smears were negative, cultures subsequently grew mycobacterium tuberculosis. Patient was diagnosed with disseminated tuberculosis. Human deficiency virus test was negative. Patient was successfully treated with anti-tuberculosis therapy. Steroid was used as adjuvant therapy due to presence of tuberculous meningitis.

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“…Although miliary tuberculosis is rare in the immunocompetent population, it is important to recognize that certain genetic defects may predispose immunocompetent individuals to disseminated tuberculosis such as abnormalities in the production or metabolism of interferon-gamma and interleukin-12, which are essential for granuloma formation and protective immunity to M. tuberculosis. Unfortunately, quantitative or qualitative tests for these cytokines are not widely available in clinical practice [7].…”

Section: Discussionmentioning

confidence: 99%

Miliary tuberculosis in an immunocompetent male

Agu¹,

Patolia²,

Basheer³

2014

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.com Miliary tuberculosis in an immunocompetent maleChidozie Charles Agu, Patolia Setu, Hiba Basheer ABSTRACT Introduction: Miliary tuberculosis (TB) is a disseminated form of tuberculosis which may involve the lungs and other organs. It is a rare but potentially lethal form of tuberculosis seen mostly in immunocompromised patients. It is, however, not commonly reported in immunocompetent hosts. Case Report: We present a case of a 67-year-old African-American male who presented with persistent non-productive cough for three weeks, diarrhea, fatigue and weight loss. There was no history of active TB contacts, HIV infection, or other predisposing factor for immunosuppression. Physical examination was also unremarkable. Chest X-ray and computed tomography scan revealed bilateral extensive small nodular infiltrates with negative serial acidfast sputum smears. Acid-fast bacilli were detected in sputum culture at four weeks and were identified by DNA probe as Mycobacterium tuberculosis. Conclusion: Miliary tuberculosis is a potentially lethal form of tuberculosis that mostly affects immunosuppressed patients, although in rare occasions can also affect immunocompetent adults.

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Unusual Presentation of a Common Disease: Disseminated Tuberculosis in an Immunocompetent Patient

Cited by 8 publications

References 5 publications

Disseminated tuberculosis with splenic involvement in an immunocompetent host: a rare entity

Disseminated tuberculosis with splenic involvement in an immunocompetent host: a rare entity

Disseminated tuberculosis in an immunocompetent patient

Miliary tuberculosis in an immunocompetent male

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