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[Miliary tuberculosis in the elderly: Case report]
María Alejandra Zambrano Gustin1, Marta Fernández Esteban1, Wendy Fuentes Ramos1
1Servicio de Geriatría y Cuidados Paliativos. Consorci Sanitari Integral. Hospital General de Hospitalet, L'Hospitalet de Llobregat, Barcelona, España.
Revista Espanola De Geriatria Y Gerontologia
|August 29, 2025
Summary
Elderly tuberculosis presents with vague symptoms, delaying diagnosis and treatment. This case highlights nonspecific signs and drug-induced liver injury in a 90-year-old man with miliary tuberculosis.
Area of Science:
- Geriatrics
- Infectious Diseases
- Pulmonology
Background:
- Tuberculosis (TB) diagnosis in the elderly is often delayed due to nonspecific symptoms.
- This leads to underdiagnosis and treatment delays, increasing morbidity and mortality.
Observation:
- A 90-year-old male presented with asthenia, anorexia, weight loss, and leg edema.
- Imaging revealed a diffuse bilateral reticulonodular pattern, deep vein thrombosis, and mediastinal lymphadenopathy.
- Pulmonary CT angiography showed a cavitated infiltrate and bilateral micronodular pattern, highly suggestive of miliary tuberculosis.
Findings:
- Tuberculosis PCR cultures confirmed the diagnosis after 72 hours.
- The patient developed jaundice and elevated liver enzymes, indicating hepatotoxicity from anti-TB drugs.
Implications:
- Nonspecific symptoms in the elderly can mask serious infections like miliary tuberculosis.
- Close monitoring for drug-induced hepatotoxicity is crucial during tuberculosis treatment in elderly patients.
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