Document Detail


Miliary tuberculosis with positive acid-fast bacilli in a pediatric patient.
MedLine Citation:
PMID:  12920475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Tuberculosis is an important public health issue. The Brazilian government reported 78,460 new cases in 1999. Miliary tuberculosis is a severe form of this disease. OBJECTIVE: To report on an uncommon clinical presentation of miliary tuberculosis in a child. CASE REPORT: A 5-year old boy presented in the emergency room with fatigue and weight loss. He had had Staphylococcus aureus pneumonia 7 months before. Chest radiography revealed lobar consolidation and miliary pattern associated with small cavities in both upper lobes. Antibiotic therapy was started. The sputum was positive for acid-fast bacilli and hence the treatment recommended for tuberculosis (rifampicin, isoniazid [INH], pyrazinamide) was started. The patient was treated for 9 months and at the end of the follow-up period he had made a complete clinical recovery. CONCLUSION: Although in some particular cases sputum can be positive for acid-fast bacilli in children, limitations to the sputum test have forced pediatricians to base tuberculosis diagnosis on epidemiological data, clinical findings and radiographic pattern. In this particular case, we hypothesize that the sputum bacillus test was positive because bacilli grew inside residual pneumatoceles that were produced during previous pneumonia.
Authors:
Sara Regina Castanheira Fernandes; Marcia Noriko de Oliveira Homa; Aghata Igarashi; Andréa Luiza Mendes Salles; Ana Paula Jaloretto; Maria Silvia Freitas; Paulo Cesar Koch Nogueira
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2003-08-08
Journal Detail:
Title:  São Paulo medical journal = Revista paulista de medicina     Volume:  121     ISSN:  1516-3180     ISO Abbreviation:  Sao Paulo Med J     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-08-15     Completed Date:  2003-10-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100897261     Medline TA:  Sao Paulo Med J     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  125-7     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Faculdade de Ciências Médicas de Santos, Santos, Brazil. sarinha_med@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Bacteriological Techniques / methods
Child, Preschool
Humans
Male
Mycobacterium tuberculosis / isolation & purification*,  metabolism
Sputum / microbiology*
Tuberculosis, Miliary / diagnosis*,  drug therapy,  radiography
Tuberculosis, Pulmonary / diagnosis*,  drug therapy,  radiography

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