A PEDIATRIC CASE OF MILIARY TUBERCULOSIS: RARE FINDINGS AND ATYPICAL COURSE

  • Carla Gomes Garcez Pediatric Department of Hospital de Braga
  • Susana Carvalho Pediatric Department of Hospital de Braga
  • Ana Antunes Pediatric Department of Hospital de Braga
  • Augusta Gonçalves Pediatric Department of Hospital de Braga
  • Carla Moreira Pediatric Department of Hospital de Braga
  • Henedina Antunes Pediatric Department of Hospital de Braga; Instituto de Investigação em Ciências da Vida e da Saúde (ICVS), Escola de Ciências da Saúde, Universidade do Minho e ICVS/3B’s - Laboratório Associado, Braga/Guimarães
Keywords: acid-fastbacilli, cerebral tuberculomas, persistent fever, tubercular choroiditis

Abstract

Bachground: Miliary tuberculosis results from lymphohematogenous dissemination of Mycobacterium tuberculosis and it’s a severe manifestation of the disease.

Case report: A nine-year old girl was admitted to our hospital with persistent fever. Acute miliary tuberculosis was diagnosed after chest radiography revealing diffuse, bilateral, small lung nodules, tubercular choroiditis in the right eye and positive acid-fast bacilli in gastric aspirate. Brain magnetic resonance imaging showed several small nodular lesions consistent with tuberculomas. Mycobacterium tuberculosis was identified in gastric aspirate cultures. Fever and positive acid-fast bacilli in gastric aspirate persisted after more than 40 days of therapy. It was excluded human immunodeficiency virus infection. No complications were reported. Later, clinical outcome was good.

Discussion: Tuberculosis remains a relevant diagnosis in children with prolonged fever. The classic image on chest radiography, tubercular choroiditis and the presence of acid-fast bacilli in gastric aspirate were essential in making a prompt diagnosis and appropriate implementation of therapy. It emphasized the importance of maintaining a high index of suspicion for a condition that is treatable.

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Published
2016-09-30
How to Cite
Garcez, C. G., Carvalho, S., Antunes, A., Gonçalves, A., Moreira, C., & Antunes, H. (2016). A PEDIATRIC CASE OF MILIARY TUBERCULOSIS: RARE FINDINGS AND ATYPICAL COURSE. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 25(3), 182-186. https://doi.org/10.25753/BirthGrowthMJ.v25.i3.10085
Section
Case Reports