Miyoshi Isao, Daibata Masanori, Kuroda Naoto, Taguchi Hirokuni, Enzan Hideaki
Department of Hematology and Respiratory Medicine, Kochi University School of Medicine.
Intern Med. 2005 Jun;44(6):622-4. doi: 10.2169/internalmedicine.44.622.
A 61-year-old woman was admitted with fever and headache of 10-day duration. She was found to have anemia, jaundice, and signs of meningitis. The erythrocyte sedimentation rate was increased and the tuberculin skin test was positive. A provisional diagnosis of miliary tuberculosis was made and antituberculous therapy was started, although no miliary lesions were seen on chest radiography. However, her condition rapidly deteriorated with diffuse opacification of both lungs and she died on the 7th hospital day. Postmortem examination revealed miliary tuberculosis in several organs but not in the lungs with acute respiratory distress syndrome accounting for the lung pathology. It should be noted that on rare occasions the lungs may not be involved by miliary tuberculosis.
