M Spandana, Yelne Seema, Chaudhary Minakshi, Agrawal Aman
Paediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Nursing, Shalinitai Meghe College of Nursing, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2023 Jul 13;15(7):e41817. doi: 10.7759/cureus.41817. eCollection 2023 Jul.
Miliary tuberculosis (TB) is characterized by the spreading of throughout the body, leading to various clinical manifestations and potential complications. This case involves a 58-year-old male who presented with fever, night sweats, weight loss, and respiratory symptoms. Diagnostic workup revealed the characteristic radiological findings of diffuse miliary nodules on CT scan and X-ray of the chest. Laboratory investigations, including a positive interferon-gamma release assay, supported the diagnosis. The patient was initiated on a multidrug anti-TB regimen consisting of rifampicin, isoniazid, pyrazinamide, and ethambutol, with adjunctive corticosteroids for severe manifestations. Close monitoring and supportive care were provided. The patient started anti-TB therapy and his health improved significantly. He was able to receive a kidney transplant successfully. The case report emphasizes the importance of early recognition, timely diagnosis, and appropriate treatment initiation to improve patient outcomes.
粟粒性肺结核的特征是结核杆菌在全身扩散，导致各种临床表现和潜在并发症。该病例为一名58岁男性，出现发热、盗汗、体重减轻及呼吸道症状。诊断检查显示胸部CT扫描和X线有弥漫性粟粒结节的典型影像学表现。包括干扰素-γ释放试验阳性在内的实验室检查支持了诊断。患者开始接受由利福平、异烟肼、吡嗪酰胺和乙胺丁醇组成的多药抗结核方案，并针对严重表现加用了皮质类固醇。给予密切监测和支持治疗。患者开始抗结核治疗后健康状况显著改善。他成功接受了肾移植。该病例报告强调了早期识别、及时诊断和适当启动治疗对改善患者预后的重要性。
