Author(s): Garcez, Carla Gomes ; Carvalho, Susana ; Antunes, Ana ; Gonçalves, Augusta ; Moreira, Carla ; Antunes, Henedina
Date: 2016
Persistent ID: https://hdl.handle.net/1822/51111
Origin: RepositóriUM - Universidade do Minho
Subject(s): Acid fast bacilli; Cerebral tuberculomas; Persistent fever; Tubercular choroiditis; Bacilos álcool ácido resistentes; Febre persistente; Tuberculomas cerebrais; Tubérculos coroideus; Ciências Médicas::Medicina Clínica
Bachground: Miliary tuberculosis results from lympho hematogenous dissemination of Mycobacterium tuberculosis and it’s a severe manifestation of the disease. Case report: A nineyear old girl was admitted to our hospital with persistent fever. Acute miliary tuberculosis was diagnosed after chest radiography revealing diffuse, bilateral, small lung nodules, tubercular choroiditis in the right eye and positive acidfast bacilli in gastric aspirate. Brain magnetic resonance imaging showed several small nodular lesions consistent with tuberculomas. Mycobacterium tuberculosis was identified in gastric aspirate cultures. Fever and positive acidfast bacilli in gastric aspirate persisted after more than 40 days of therapy. It was excluded human immunodeficiency virus infection. No complications were reported. Later, clinical outcome was good. Discussion: Tuberculosis remains a relevant diagnosis in children with prolonged fever. The classic image on chest radiography, tubercular choroiditis and the presence of acidfast bacilli in gastric aspirate were essential in making a prompt diagnosis and appropriate implementation of therapy. It emphasized the importance of maintaining a high index of suspicion for a condition that is treatable.
