Miliary tuberculosis associated with adrenal enlargement: CT appearance

Area of Science:

• Radiology
• Infectious Diseases
• Endocrinology

Background:

• Miliary tuberculosis is a severe disseminated form of Mycobacterium tuberculosis infection.
• Early diagnosis is crucial for effective treatment and improved patient outcomes.
• Adrenal gland involvement can occur in disseminated tuberculosis but may be overlooked.

Observation:

• Computed tomography (CT) scans were utilized to evaluate two patients presenting with suspected miliary tuberculosis.
• CT imaging revealed characteristic findings suggestive of disseminated tuberculosis.
• Specific attention was given to the adrenal glands, which are potential sites of tuberculous involvement.

Findings:

• CT imaging initially suggested the diagnosis of miliary tuberculosis in both patients.
• Histopathological examination confirmed tuberculosis in both cases.
• Bacteriological confirmation of tuberculosis was achieved in one of the two patients.
• CT demonstrated adrenal gland enlargement, presenting as unilateral in one patient and bilateral in the other.

Implications:

• CT imaging can be a valuable tool for the early suspicion of miliary tuberculosis.
• The findings highlight the importance of evaluating the adrenal glands in patients with disseminated tuberculosis.
• Recognizing adrenal involvement on CT may prompt earlier and more targeted diagnostic and therapeutic interventions.