Miliary tuberculosis in a paediatric patient with psoriasis
Autor: | Samrat U Das, Bradford Becken, Jacob T. Kilgore, Jonathon Pelletier, Stephen Kenny, Lisa Parnell |
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Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
drugs and medicines Miliary tuberculosis Pediatrics medicine.medical_specialty Tuberculosis Adolescent medicine.medical_treatment 030106 microbiology TB and other respiratory infections Case Report infectious diseases 03 medical and health sciences Immunocompromised Host 0302 clinical medicine Psoriasis medicine Humans Right upper lobe 030212 general & internal medicine infections Child Paediatric patients business.industry Tuberculosis Miliary paediatrics (drugs and medicines) Immunosuppression General Medicine Emergency department medicine.disease Magnetic Resonance Imaging Pneumonia Female business Tomography X-Ray Computed |
Zdroj: | BMJ Case Reports |
ISSN: | 1757-790X |
Popis: | We present a 16-year-old girl with a history of well-controlled psoriasis, on immunosuppression, who sought evaluation in the emergency department for 4 months of fever, cough and unintentional weight loss. The patient had seen multiple providers who had diagnosed her with community-acquired pneumonia, but she was unimproved after oral antibiotic therapy. On presentation, she was noted to be febrile, tachycardic and chronically ill-appearing. Her chest X-ray showed diffuse opacities and a right upper lobe cavitary lesion concerning for tuberculosis. A subsequent chest CT revealed miliary pulmonary nodules in addition to the cavitary lesion. The patient underwent subsequent brain MRI, which revealed multifocal ring-enhancing nodules consistent with parenchymal involvement. The patient was diagnosed with miliary tuberculosis and improved on quadruple therapy. Though rates of tuberculosis are increasing, rates remain low in children, though special consideration should be given to children who are immunosuppressed. |
Databáze: | OpenAIRE |
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