Miliary tuberculosis – A challenging diagnosis

Authors

  • Catarina Pinto Silva Department of Pediatrics, Unidade Local de Saúde de Coimbra https://orcid.org/0000-0001-6728-4149
  • Beatriz de Sousa Department of Pediatrics, Centro Materno-Infantil do Norte, Unidade Local de Saúde de Santo António https://orcid.org/0000-0001-9681-6837
  • Joana Lima Department of Pediatrics, Unidade Local de Saúde do Alto Ave https://orcid.org/0000-0002-5232-0239
  • Sofia Vasconcelos Department of Pediatrics, Centro Materno-Infantil do Norte, Unidade Local de Saúde de Santo António
  • Alícia Rebelo Department of Pediatrics, Centro Materno-Infantil do Norte, Unidade Local de Saúde de Santo António https://orcid.org/0000-0002-5713-2333
  • Ana Luísa Lobo Department of Pediatrics, Centro Materno-Infantil do Norte, Unidade Local de Saúde de Santo António
  • Alexandre Fernandes Department of Pediatrics, Unidade Local de Saúde do Alto Ave https://orcid.org/0000-0002-0532-2178

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v33.i3.27681

Keywords:

Bacillus Calmette-Guerin vaccine, disseminated tuberculosis, meningitis, miliary tuberculosis, tuberculosis

Abstract

Tuberculosis is a challenging diagnosis with marked clinical heterogeneity that can lead to diagnostic delay and serious and potentially life-threatening problems. The most prevalent form of the disease is pulmonary tuberculosis. The present case has unique features as in that it describes a case of miliary tuberculosis in an immunocompetent adolescent vaccinated with the Bacillus Calmette-Guerin vaccine and raises awareness of the occurrence of normal radiograph and early in the course of pulmonary tuberculosis, and normal head tomography even in the presence of tuberculous meningitis, highlighting the need for a high index of suspicion. It also shows that tuberculosis should be included in the differential diagnosis of fever of unknown origin with weight loss, even when no epidemiologic link has been established.

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References

Chenciner L, Annerstedt KS, Pescarini JM, Wingfield T. Social and health factors associated with unfavourable treatment outcome in adolescents and young adults with tuberculosis in Brazil: a national retrospective cohort study. Lancet Glob Heal [Internet]. 2021;9(10):e1380–90. Available from: http://dx.doi.org/10.1016/S2214-109X(21)00300-4.

World Health Organization. Global tuberculosis report 2021.

García-Basteiro AL, Simon Schaaf H, Diel R, Migliori GB. Adolescents and young adults: A neglected population group for tuberculosis surveillance. Eur Respir J [Internet]. 2018;51(2):1–4. Available from: http://dx.doi.org/10.1183/13993003.00176-2018.

Snow KJ, Sismanidis C, Denholm J, Sawyer SM, Graham SM. The incidence of tuberculosis among adolescents and young adults: A global estimate. Eur Respir J [Internet]. 2018;51(2). Available from: http://dx.doi.org/10.1183/13993003.02352-2017.

Underwood J, Cresswell F, Salam AP, Keeley AJ, Cleland C, John L, et al. Complications of miliary tuberculosis: Low mortality and predictive biomarkers from a UK cohort. BMC Infect Dis. 2017;17(1):1–7.

Garg RK, Sharma R, Kar AM, Kushwaha RAS, Singh MK, Shukla R, et al. Neurological complications of miliary tuberculosis. Clin Neurol Neurosurg [Internet]. 2010;112(3):188–92. Available from: http://dx.doi.org/10.1016/j.clineuro.2009.11.013.

Sharma SK, Mohan A, Sharma A. Miliary tuberculosis: A new look at an old foe. J Clin Tuberc Other Mycobact Dis [Internet]. 2016;3:13–27. Available from: http://dx.doi.org/10.1016/j.jctube.2016.03.003.

Sentís A, Prats-Uribe A, Peixoto VR, Caylà JA, Gomes MD, Sousa S, et al. Decline of tuberculosis notification rate in different populations and regions in Portugal, 2010–2017. Pulmonology. 2021. Available from: https://doi.org/10.1016/j.pulmoe.2021.08.002.

Direção Geral da Saúde. Relatório de vigilância e monitorização da tuberculose em Portugal. 2021.

Margarit A, Simó S, Rozas L, Deyà-Martínez À, Barrabeig I, Gené A, et al. Tuberculosis en el adolescente; reto y oportunidad de evitar el contagio a la comunidad. An Pediatr [Internet]. 2017;86(3):110–4. Available from: http://dx.doi.org/10.1016/j.anpedi.2016.03.009.

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Published

2024-10-22

How to Cite

1.
Pinto Silva C, de Sousa B, Lima J, Vasconcelos S, Rebelo A, Lobo AL, et al. Miliary tuberculosis – A challenging diagnosis. BGMJ [Internet]. 2024 Oct. 22 [cited 2026 Jan. 12];33(3):186-90. Available from: https://revistas.rcaap.pt/bgmj/article/view/27681

Issue

Vol. 33 No. 3 (2024)

Section

Clinical Case Reports

License

Copyright (c) 2024 Catarina Pinto Silva, Beatriz de Sousa, Joana Lima, Sofia Vasconcelos, Alícia Rebelo, Ana Luísa Lobo, Alexandre Fernandes

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