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Miliary tuberculosis in a paediatric patient with psoriasis
Jacob Kilgore1, Jonathon Pelletier2, Bradford Becken3
1Division of Pediatric Infectious Diseases, Duke University Hospital, Durham, North Carolina, USA.
BMJ Case Reports
|March 10, 2021
Summary
A 16-year-old girl with immunosuppression presented with persistent symptoms initially misdiagnosed as pneumonia. She was diagnosed with miliary tuberculosis affecting the lungs and brain, highlighting the need for vigilance in immunocompromised children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Radiology
Background:
- Immunosuppression increases susceptibility to opportunistic infections.
- Tuberculosis (TB) incidence is rising globally.
- Pediatric TB is less common but poses diagnostic challenges.
Observation:
- A 16-year-old girl with psoriasis on immunosuppression presented with prolonged fever, cough, and weight loss.
- Initial diagnosis of community-acquired pneumonia was unresponsive to antibiotics.
- Imaging revealed diffuse pulmonary opacities, a cavitary lesion, miliary nodules, and brain lesions.
Findings:
- Miliary tuberculosis with pulmonary and parenchymal brain involvement was diagnosed.
- The patient showed clinical improvement with standard quadruple anti-TB therapy.
- Diagnostic imaging, including chest X-ray, CT, and brain MRI, was crucial.
Implications:
- This case underscores the importance of considering tuberculosis in immunocompromised children with persistent respiratory symptoms.
- Early and accurate diagnosis through advanced imaging is vital for effective treatment.
- Increased awareness of pediatric TB in at-risk populations is necessary.
Keywords:
TB and other respiratory infectionsdrugs and medicinesinfectionsinfectious diseasespaediatrics (drugs and medicines)More Related Videos
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