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Miliary Tuberculosis with Severe Pneumonia without Abnormal Chest Sounds in a Covid-19 Pandemic

Atana Uket Ewa, Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Glory Ekpo Bassey, Ubong Aniefiok Udoh, Enobong Ufot Akpah, Kingsley Chidi Anachuna, Bassey Ewa Ekeng, Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar.
2021 Journal of Tuberculosis  

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Tuberculosis (TB) is still causing deaths in children in TB endemic countries. Majority (80%) occur in the lungs, with 5% being miliary TB. It is an Interstitial Lung Disease (ILD) with similar clinical, physiological and radiological features to other ILD and affects mainly infants and children with a high mortality rate despite available treatment. Case Presentation: A three-month old male presented during the COVID-19 pandemic with fever of 2 weeks, cough of one week, fast and difficult
more » ... hing of 6 days' duration. He received BCG vaccine 16 days after birth despite being unknowingly exposed to the TB contact from birth. He was acutely ill looking, with severe pneumonia and SPO2 of 76% in room air. Respiratory examination showed broncho vesicular breath sounds with no added sounds. A diagnosis of Severe pneumonia? Pneumocystis Jiroveci Pneumonia (PJP) and R/O COVID-19 was made. Subsequent reviews excluded PJP and COVID-19 and the final diagnosis was Disseminated (Miliary) TB. He was successfully treated with anti-TB medications for 12 months. Conclusion: Miliary TB presents with common and uncommon manifestations that may be confusing, and so a high index of suspicion with a careful history, focused systemic examination, imaging and bacteriological studies are strongly recommended for its early diagnosis.
doi:10.33582/2640-1193/1028 fatcat:vsg7oghxe5cythaplolejzhl5i
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Atana Uket Ewa, Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Glory Ekpo Bassey, Ubong Aniefiok Udoh, Enobong Ufot Akpah, Kingsley Chidi Anachuna, Bassey Ewa Ekeng, Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar., Medical Microbiology and Parasitology University ofCalabar Teaching Hospital Calabar.. "Miliary Tuberculosis with Severe Pneumonia without Abnormal Chest Sounds in a Covid-19 Pandemic." Journal of Tuberculosis 4.1 (2021)