A Case Report of Widely Disseminated Tuberculosis in Immunocompetent Adult Male
| Autor: | Joseph Levi, Alexandra Amaducci, Samantha B Esposito, Zachary Matuzsan, David M. Richardson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Pediatrics
medicine.medical_specialty Disseminated tuberculosis Tuberculosis Emergency Nursing immunocompetent adult 03 medical and health sciences 0302 clinical medicine medicine case report 030212 general & internal medicine medicine.diagnostic_test Lumbar puncture business.industry Meninges lcsh:Medical emergencies. Critical care. Intensive care. First aid Emergency department lcsh:RC86-88.9 medicine.disease medicine.anatomical_structure Emergency Medicine tuberculosis meningitis Headaches medicine.symptom Chest radiograph business Meningitis 030217 neurology & neurosurgery Encephalitis miliary tuberculosis |
| Zdroj: | Clinical Practice and Cases in Emergency Medicine, Vol 4, Iss 3 (2020) Clinical Practice and Cases in Emergency Medicine |
| Popis: | Author(s): Esposito, Samantha B.; Levi, Joseph; Matuzsan, Zachary M.; Amaducci, Alexandra M.; Richardson, David M. | Abstract: Introduction: Disseminated tuberculosis (TB) is rare, affects any organ system, and presents mainly in immunocompromised populations. Typical presentation is non-specific, posing a challenge for diagnosis.Case Report: This case presents an immunocompetent male presenting with severe headaches with meningeal signs. Lab and lumbar puncture results suggested bacterial meningitis, yet initial cerebral spinal fluid cultures and meningitis/encephalitis polymerase chain reaction were negative. A chest radiograph (CXR) provided the only evidence suggesting TB, leading to further tests showing dissemination to the brain, spinal cord, meninges, muscle, joint, and bone.Discussion: This case stands to acknowledge the difficulty of diagnosis in the emergency department (ED), and the need for emergency physicians to maintain a broad differential including disseminated TB as a possibility from the beginning of assessment. In this case, emergency physicians should be aware of predisposing factors of disseminated TB in patients presenting with non-specific symptoms. They should also acknowledge that TB may present atypically in patients with minimal predisposing factors, rendering the need to further investigate abnormal CXR images despite lab results inconsistent with TB.Conclusion: While this diagnosis is easily missed, early identification in the ED can lead to optimal treatment. |
| Databáze: | OpenAIRE |
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