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At least 991 records · Page 55Linked to original sources
PubMed1992

Miliary tuberculosis with acute respiratory failure and histiocytic hemophagocytosis. Successful treatment with extracorporeal lung support and epipodophyllotoxin VP 16-213.

A 14-year-old girl with high fever, dyspnea and bilateral miliary nodules on chest X-ray, developed a rapidly progressive respiratory failure associated with histiocytic hemophagocytosis. Histologic examination of bone marrow biopsy revealed tuberculous granulomas with caseating necrosis. We report a pediatric case in which treatment with extracorporeal lung support and epipodophyllotoxin VP 16-213 was successful.

Adolescent↗
PubMedDate not supplied

Miliary tuberculosis with bilateral pneumothorax: a rare complication.

A 15-year-old girl presented with a history of cough, fever for five months and breathlessness of two days duration. Her chest roentgenogram showed bilateral miliary shadows with a left sided pneumothorax. Shortly afterwards, she developed a pneumothorax on the other side also. She was managed with intercostal tube drainage on both sides and antitubercular treatment. She made an uneventful recovery.

Adolescent↗
PubMed2003

Abdominal miliary tuberculosis in a patient with AIDS: a case report.

We present a 34 year old patient, intravenous drug user, hospitalized with fever, distortion of general status, dry irritating cough, abdominal colicative pains, and we established the diagnosis of HIV infection advanced stage/AIDS; his antecedents revealed (August 2000) abdominal tuberculosis not treated during the last 3 months. He presented a pneumonia with Pneumocystis carinii during hospitalization. Death was due to a colon perforation with secundary peritonitis. Miliary tuberculous lesions in liver, spleen and colon were revealed at necropsy and cytomegalovirus was identified in necrotic samples also.

AIDS-Related Opportunistic Infections↗
PubMed2003

Bilateral pneumothorax complicating miliary tuberculosis in children: case report and review of the literature.

An 11-year-old boy presented with a 4-week history of fever and 2 weeks later developed a cough with breathlessness. His chest X-ray showed bilateral miliary shadows with pneumothorax on the left side. While on antituberculous therapy which was started on admission, he developed right-sided pneumothorax with significant collapse of the left lung. He was managed by tube thoracotomy with underwater seal but died 4 hours after the procedure was completed.

Antitubercular Agents↗
PubMed1988

Miliary tuberculosis in an in-vitro fertilization pregnancy: a case report.

A 33-yr-old woman with primary infertility of no known cause of 10 years duration underwent in-vitro fertilization. Mild flu-like symptoms and intermittent vaginal bleeding developed, and miliary mottling was seen throughout both lung fields. At 14 weeks she aborted a normal male fetus; urine culture was positive for M. bovis. Six months later, after a course of antituberculous drugs, the patient was symptom-free.

Adult↗
PubMed1997

Unusual miliary tuberculosis presenting with generalized lymphadenopathy and abdominal involvement.

Although tuberculosis is common and well recognised in many countries, unusual presentations of the disease sometimes raise difficulties in differential diagnosis. We report a young patient who presented with weight loss, shortness of breath and easy fatiguability. Extensive lymphadenopathy involving the cervical, axillary and inguinal regions were found on physical examination. Chest X-ray and computed tomography revealed generalized lymphadenopathy of cervical, mediastinal and para-aortic chains, bilateral pulmonary miliary reticulonodular infiltrates, pleural effusion, hepatomegaly with low density, macronodular hypodense areas in spleen, ascites, peritoneal irregularity and thickening of bowel walls. Mantoux test was negative. Peritoneal fluid was exudative, but pleural fluid was transudative, probably due to mediastinal lymphatic obstruction. The initial clinical diagnosis was malignant lymphoma; however, positive sputum smears for mycobacteria and excisional cervical lymph node biopsy revealing caseating granulomatous lymphadenitis were consistent with tuberculosis. The patient responded well to appropriate therapy with regression of radiological abnormalities.

Adult↗
PubMedDate not supplied

Non immunological analytic data for the differential diagnosis between miliary tuberculosis (MTBC) and bird breeder's disease (BBD).

A group of 86 patients diagnosed as having MTBC were compared to a group of 25 patients with BBD on the basis of various blood values included in routine analysis (hemogram, leukocyte count and differential, blood electrolyte values, urea, creatinine, total proteins and proteinogram). After statistical evaluation of the results, we concluded that the finding of low values for hemoglobin, and red blood cell (RBC) count and hematocrit, alterations of leukocyte count and differential, hypoalbuminemia, and hyponatremia, in a patient with fever and a miliary chest X-ray pattern, supports the diagnosis of MTBC. On the other hand, normal values for the above parameters, together with hypergammaglobulinemia favors the diagnosis of BBD. Our data also demonstrated a 79% mortality rate in patients with MTBC and plasma urea levels of more than 55 mg/100 ml (p less than 0.001).

Alveolitis, Extrinsic Allergic↗
PubMed1993

Protective effect of BCG against tuberculous meningitis and miliary tuberculosis: a meta-analysis.

The protective effect of BCG against tuberculosis (TB) estimated in randomized controlled trials and observational studies ranges from negative to close to a 100%. One of the many explanations offered for this is that different immunological mechanisms may be associated with protective effect against different forms and sites of disease. In this investigation, we recalculated vaccine protective effect separately for pulmonary disease and for meningeal/miliary disease in randomized controlled trials and case-control studies, tested for heterogeneity in site-specific estimates of protective effect and calculated a summary measure when appropriate. We found protective effect against pulmonary disease to be heterogeneous to a statistically significant degree, and thus we did not calculate a summary measure of protection. Protective effect against meningeal and miliary TB was higher than against pulmonary disease and, except for a single study with two cases only, appeared to be homogenous. Summary BCG protective effect against miliary or meningeal TB in randomized controlled trials was 86% (95% confidence interval [CI] 65, 95) and in case-control studies 75% (95% CI: 61, 84). The fact that protective effect appeared to be homogeneous against meningitis and miliary TB but not against pulmonary disease may result from the fact that patients with meningitis are on average younger and thus less likely to have been exposed to atypical bacteria; to a waning of the protective effect of BCG; or from the diversity of mechanisms of pathogenesis of pulmonary disease, which can originate from reinfection, reactivation or primary progression.

BCG Vaccine↗
PubMed2002

Cutaneous tuberculosis: diagnosis and treatment.

As we move into the 21st century, cutaneous tuberculosis has re-emerged in areas with a high incidence of HIV infection and multi-drug resistant pulmonary tuberculosis. Mycobacterium tuberculosis, Mycobacterium bovis, and the BCG vaccine cause tuberculosis involving the skin. True cutaneous tuberculosis lesions can be acquired either exogenously or endogenously, show a wide spectrum of morphology and M. tuberculosis can be diagnosed by acid-fast bacilli (AFB) stains, culture or polymerase chain reaction (PCR). These lesions include tuberculous chancre, tuberculosis verrucosa cutis, lupus vulgaris, scrofuloderma, orificial tuberculosis, miliary tuberculosis, metastatic tuberculosis abscess and most cases of papulonecrotic tuberculid. The tuberculids, like cutaneous tuberculosis, show a wide spectrum of morphology but M. tuberculosis is not identified by AFB stains, culture or PCR. These lesions include lichen scrofulosorum, nodular tuberculid, most cases of nodular granulomatous phlebitis, most cases of erythema induratum of Bazin and some cases of papulonecrotic tuberculid. Diagnosis of cutaneous tuberculosis is challenging and requires the correlation of clinical findings with diagnostic testing; in addition to traditional AFB smears and cultures, there has been increased utilization of PCR because of its rapidity, sensitivity and specificity. Since most cases of cutaneous tuberculosis are a manifestation of systemic involvement, and the bacillary load in cutaneous tuberculosis is usually less than in pulmonary tuberculosis, treatment regimens are similar to that of tuberculosis in general. In the immunocompromised, such as an HIV infected patient with disseminated miliary tuberculosis, rapid diagnosis and prompt initiation of treatment are paramount. Unfortunately, despite even the most aggressive efforts, the prognosis in these individuals is poor when multi-drug resistant mycobacterium are present. An increased awareness of the re-emergence of cutaneous tuberculosis will allow for the proper diagnosis and management of this increasingly common skin disorder.

Acquired Immunodeficiency Syndrome↗
PubMed1998

[Classification and concept of mycobacterial infections].

Mycobacterial infections are consisted of three categories; tuberculosis, nontuberculous mycobacterioses, and leprosy. Tuberculosis is a systemic infectious disease involving respiratory, genitourinary and lymphatic systems caused by Mycobacterium tuberculosis complex (Mycobacterium tuberculosis, M. bovis, M. africanum, and M. microti). Extrapulmonary tuberculosis remains a significant clinical problem because symptoms and signs may be difficult to recognize and to relate to tuberculosis. Miliary tuberculosis is responsible for up to 10% of predominantly extrapulmonary cases. HIV-related miliary tuberculosis is rapidly progressive and almost always fatal without treatment. Nontuberculous mycobacteria (NTM) have been commonly implicated as opportunistic pathogens in patients with underlying disease or immunosuppression including AIDS. M. avium complex (M. avium and M. intracellulare) and M. kansashii are most common causes of nontuberculous mycobacterial diseases in humans. M. leprae is the causative agent of leprosy, an infection of the skin, mucous membranes, and peripheral nerves. This disease is rare in Japan, yet it remains a major problem in some part of the world.

Female↗