Miliary tuberculosis: an atypical presentation

Authors

  • N. Santosh Kumar Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India
  • Ravi Prakash Naulakha Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India
  • Ipsita Vashishtha Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India
  • Neelu Elon Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India
  • Rajdeep Pal Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India
  • Prithi Inamdar Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India
  • Rajesh Rai Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20212058

Keywords:

Miliary TB, Hepatosplenomegaly, Gene Xpert, Choroid tubercles, HRCT

Abstract

Miliary tuberculosis (TB) is a severe form of disseminated TB. In developing countries childhood miliary TB is a significant health problem. Pulmonary TB is the most common type of TB in children. Of all TB cases miliary TB accounts for about 1%. We report a case of paediatric miliary TB with acute presentation in a eleven years old female who presented with fever and cough since 3 days and rapid breathing since one day. Clinical examination showed hepatosplenomegaly, on auscultation chest was clear and air entry bilateral equal, chest x-ray was suggestive of miliary shadows suggestive of TB and it was confirmed by HRCT chest. Laboratory studies revealed anaemia and elevated erythrocyte sedimentation rate (ESR). Tuberculin test was negative, gastric lavage for acid-fast bacilli Gene-Xpert was positive for mycobacterium tuberculosis. Fundus examination revealed bilateral small, white sub retinal opacities with the classical appearance of choroidal tubercles. The diagnosis of Miliary TB was confirmed and the patient was started on anti TB therapy.

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Author Biography

N. Santosh Kumar, Department of Paediatrics, D. Y. Patil University School of Medicine, Navi Mumbai, Maharashtra, India

PAEDIATRICS RESIDENT

References

World Health Organization. Roadmap for Childhood Tuberculosis: Towards Zero Deaths. Geneva: WHO; 2013. Available at: http://apps.who.int/iris/bitstream/10665/89506/1/ 9789241506137_eng.pdf. Accessed on 10th March 2021.

Mert A, Arslan F, Kuyucu T. Miliary tuberculosis: epidemiological and clinical analysis of large-case series from moderate to low tuberculosis endemic Country. Medicine. 2017;96:e5875.

Kapoor VK. Abdominal tuberculosis. Postgrad Med J. 1998;74:459-67.

De Benedetti ZME, Carranza LB, Gotuzzo HE, Rolando CI. Ocular tuberculosis. Rev Chilinfectol. 2007;24:284-95.

Hamzaoui A, Yaalaoui S, Cherif FT, Saidi LS, Berraies A. Childhood tuberculosis: a concern of the modern world. Eur Respir Rev. 2014;23:278-91.

Sharma SK, Mohan A, Sharma A. Challenges in the diagnosis & treatment of miliary tuberculosis. Indian J Med Res. 2012;135:703-30.

Overview Miliary tuberculosis. Medscape. 2019. https://emedicine.medscape.com/article/221777-overview. Accessed on 30th November, 2017.

Hussey G, Chisholm T, Kibel M. Miliary tuberculosis in children: a review of 94 cases. Pediatr Infect Dis J. 1991;10:832-6.

Gurkan F, Bosnak M, Dikici B. Miliary tuberculosis in children: a clinical review. Scand J Infect Dis. 1998;30:359-62.

Hasanzadeh M, Naderi HR, Hoshyar AH, Shabane S, Shahidsales S. Female genital tract tuberculosis presenting as ovarian cancer. J Res Med Sci. 2014;19:184-9.

Thilothammal N, Krishnamurthy PV, Runyan DK, Banu K. Does BCG vaccine prevent tuberculous meningitis. Arch Dis Child. 1996;74:144-7.

Parashar D, Kabra SK, Lodha R, Singh V, Mukherjee A. Delhi pediatric TB study group. does neutralization of gastric aspirates from children with suspected intrathoracic tuberculosis affect mycobacterial yields on MGIT culture? J Clin Microbiol. 2013;51(6):1753-6.

Khan MA, Mirza SH, Abbasi SA, Butt T, Anwar M. Peripheral blood-based polymerase chain reaction in diagnosis of pulmonary tuberculosis. J Ayub Med Coll Abbottabad. 2006;18(2):25-8.

Shiono T, Abe S, Horiuchi T. A case of miliary tuberculosis with disseminated choroidal hemorrhages. BJO. 1990;74:317-9.

Sharma SK, Mohan A, Pande JN. Clinical profile, laboratory characteristics and outcome in miliary tuberculosis. Q J Med. 1995;88:29-37.

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Published

2021-05-25

How to Cite

Kumar, N. S., Naulakha, R. P., Vashishtha, I., Elon, N., Pal, R., Inamdar, P., & Rai, R. (2021). Miliary tuberculosis: an atypical presentation. International Journal of Contemporary Pediatrics, 8(6), 1111–1113. https://doi.org/10.18203/2349-3291.ijcp20212058

Issue

Section

Case Reports