Resumen

GARCEZ, Carla Gomes et al. A pediatric case of miliary tuberculosis: rare findings and atypical course. Nascer e Crescer [online]. 2016, vol.25, n.3, pp.182-186. ISSN 0872-0754.

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.

Palabras clave : acid­fastbacilli; cerebral tuberculomas; persistent fever; tubercular choroiditis.

        · resumen en Portugués     · texto en Portugués     · Portugués ( pdf )