Miliary tuberculosis in the XXI century - a case report


  • Liliana Pinho Paediatric Service of Centro Hospitalar do Porto
  • Sara Oliveira Paediatric Service of Centro Hospitalar Vila Nova de Gaia-Espinho
  • Josefina Serino Ophthalmology Service of Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos
  • Teresa Febra Centro de Diagnóstico Pneumológico - Póvoa de Varzim-Vila do Conde
  • Sandra Ramos Paediatric Service of Centro Hospitalar Póvoa de Varzim-Vila do Conde
  • Conceição Silva Centro de Diagnóstico Pneumológico - Póvoa de Varzim-Vila do Conde
  • Maria José Dinis Paediatric Service of Centro Hospitalar Póvoa de Varzim - Vila do Conde; Centro de Diagnóstico Pneumológico - Póvoa de Varzim-Vila do Conde



Children, miliary, tuberculosis


Introduction: Tuberculosis is still a serious public health problem. Young age and HIV infection are important risk factors for severe or disseminated disease.

Case report: We report the case of a three-year-old girl who presented a prolonged fever without a source on physical examination. Initial laboratory fi ndings were suggestive of urinary tract infection and empirical antibiotic therapy was started. Urine culture confi rmed that diagnosis, but fever had persisted. On complementary investigation, chest X-ray revealed an< infiltrate with a miliary pattern. Mycobacterium tuberculosis was isolated on gastric aspirate, cerebrospinal fluid and urine. Antituberculous therapy and corticoid were initiated with signifi cant clinical improvement.

Conclusions: Even in this era of advanced medical technology, tuberculosis is still a diagnostic challenge, especially when the presentation is atypical and extra-pulmonary. A high index of suspicion by the physician is required because prompt institution of adequate treatment is decisive for fi nal outcome.


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Ávalos GGL, Montes de Oca EP. Classic and new diagnostic approaches to childhood tuberculosis. Journal of Tropical Medicine 2012. doi:10.1155/2012/818219

Direcção-Geral da Saúde. Programa Nacional de Luta Contra a Tuberculose. Ponto da Situação Epidemiológica e de Desempenho – Relatório para o Dia Mundial da Tuberculose, Março 2013.

Marais BJ, Schaaf HS. Childhood tuberculosis: An emerging and previously neglected problem. Infect Dis Clin N Am 2010; 24:727-49.

Newton SM, Brent AJ, Anderson S, Whittaker E, Kampmann B. Paediatric tuberculosis. Lancet Infect Dis 2008; 8:498-510.

Marais BJ, Graham SM, Cotton MF, Beyers N. Diagnostic and management challenges for childhood tuberculosis in the era of HIV. J Infect Dis 2007; 196:S76-85.

Moreno-Pérez D, Martín AA, Gómez NA, Baquero-Artigao F, Montaner AE, Durán GPA, et al. Diagnóstico de la tuberculosis en la edad pediátrica. Documento de consenso de la Sociedad Espanola de Infectología Pediátrica y la Sociedad Espanola de Neumología Pediátrica. An Pediatr (Barc) 2010; 73: 143.e1-143.e14.

Stop TB Partnership Childhood TB Subgroup. Chapter 1: Introduction and diagnosis of tuberculosis in children. Int J Tuberc Lung Dis 2006; 10:1091-7.

American Thoracic Society. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med 2000; 161:1376-95.

Starke JR, Munoz FM. Tuberculosis (Mycobacterium Tuberculosis). In: Kliegman: Nelson Textbook of Pediatrics. Philadelphia: Saunders Elsevier; 2007. Ch. 212. p.1240-54.

Cruz AT, Starke JR. Pediatric tuberculosis. Pediatrics in Review. 2010; 31 (1): 13-25.

Bento J, Silva AS, Rodrigues F, Duarte R. Métodos diagnósticos em tuberculose. Acta Med Port 2011; 24:145-54.

Stop TB Partnership Childhood TB Subgroup. Chapter 2: Anti-tuberculosis treatment in children. Int J Tuberc Lung Dis 2006; 10:1205-11.

Asociación Espanola de Pediatria. Grupo de Trabajo de Tuberculosis de la Sociedad Española de Infectología Pediátrica (SEIP). Documento de consenso sobre el tratamiento de la tuberculosis extrapulmonar y formas complicadas de tuberculosis pulmonar. An Pediatr (Barc) 2008;69:271-8.

Thwaites G, Fisher M, Hemingway C, Scott G, Solomon T, Innes J. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. J Infect 2009; 59:167-87.

Centre for Disease Control. Department of Health and Community Services. Guidelines for the Control of Tuberculosis in the Northern Territory; 4th ed. 2008. p. 25.



How to Cite

Pinho L, Oliveira S, Serino J, Febra T, Ramos S, Silva C, Dinis MJ. Miliary tuberculosis in the XXI century - a case report. REVNEC [Internet]. 2016Mar.1 [cited 2024May29];23(3):151-4. Available from:



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