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Case Reports
. 2023 Jan 18;15(1):e33944.
doi: 10.7759/cureus.33944. eCollection 2023 Jan.

Miliary Tuberculosis with Acute Respiratory Distress Syndrome: A Deadly Combination

Gaurang M Aurangabadkar  1 , Ulhas S Jadhav  2 , Sumer S Choudhary  1 , Shafee M Khan  1 , Pankaj Wagh  2 , Puja Upadhyay  2
Affiliations
Case Reports

Miliary Tuberculosis with Acute Respiratory Distress Syndrome: A Deadly Combination

Gaurang M Aurangabadkar et al. Cureus. .

Abstract

A unique and deadly presentation of miliary tuberculosis is acute respiratory distress syndrome. In this case report, we present the case of a 22-year-old male patient who presented with a history of weight loss, appetite loss for eight months, and rapidly worsening dyspnea for 15 days, for which he was admitted to the intensive care unit. Chest X-ray and computed tomography (CT) of the thorax revealed bilateral miliary opacities. Routine blood tests revealed hyponatremia and leukocytosis. The patient was started on non-invasive ventilatory support, intravenous corticosteroids, and anti-tubercular therapy on clinical and-radiological suspicion of miliary tuberculosis. The patient was admitted for one month and started to show rapid recovery after initiating anti-tubercular and corticosteroid therapy.

Keywords: acute respiratory distress syndrome; antitubercular therapy; dexamethasone; hyponatremia; miliary tuberculosis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Chest X-ray with a posteroanterior (PA) view on admission showing bilateral symmetrical miliary opacities (yellow arrows).
Figure 2
Figure 2. Contrast-enhanced computerized tomography (CT) scan of the chest showing bilateral multiple centrilobular nodules with tree-in-bud appearance (red arrows).
See this image and copyright information in PMC

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