Sasaki Y, Yamagishi F, Mizutani F, Yagi T, Tada Y, Sakao S
Thoracic Department of National Chiba Higashi Hospital, Japan.
Kekkaku. 1998 May;73(5):355-9.
A 30-year-old-man was admitted to our hospital because of headache and fever. His consciousness on admission was clouding. Sputum examination was positive for acid fast bacilli which later identified as Mycobacterium tuberculosis. Chest-X-ray and computed tomogram on admission showed multiple cavitary lesions on bilateral upper lung fields and bilateral diffuse nodular shadow. He was diagnosed as miliary tuberculosis with tuberculous meningitis. His mother admitted because of pulmonary tuberculosis four months ago, and her sputum examination was smear positive for acid fast bacilli, Gaffky 4, and she complained of cough for 6 months before admission. Because of this situation, he rapidly underwent the contact examination with chest X-ray, but not examined by tuberculin skin test because he was 30-year-old. As then chest X-ray was normal, he was not indicated of chemoprophylaxis, and he died of miliary tuberculosis and tuberculous meningitis 4 months after the contact examination.
一名30岁男性因头痛和发热入院。入院时意识模糊。痰检抗酸杆菌阳性,后鉴定为结核分枝杆菌。入院时胸部X线和计算机断层扫描显示双侧上肺野有多个空洞性病变及双侧弥漫性结节状阴影。他被诊断为粟粒性肺结核合并结核性脑膜炎。他的母亲四个月前因肺结核入院,痰检抗酸杆菌涂片阳性,加夫基4级,入院前咳嗽6个月。鉴于这种情况,他迅速接受了胸部X线接触检查,但因他30岁未进行结核菌素皮肤试验。当时胸部X线正常,未对他进行化学预防,接触检查4个月后他死于粟粒性肺结核和结核性脑膜炎。