Miliary tuberculosis in an Indian lady: Looking beyond miliary tuberculosis

Abstract

Presence of miliary shadows in chest imaging in the appropriate clinical setting is often taken as a marker of miliary tuberculosis. If sputum is negative for acid -fast bacillus, empirical anti-tubercular therapy is given without securing a histological or microbiological diagnosis. We report a young female with human immunodeficiency virus infection who had miliary infiltrates on chest radiography. She was started on empirical anti-tubercular therapy. But an alternate diagnosis was achieved later with invasive sampling and ATT was stopped. This case illustrates the need for physicians to remain alert to diseases which mimic tuberculosis in presentation.

Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis

“…Only a few cases of miliary histoplasmosis have been described in the literature. A comparison of our case to other cases of miliary histoplasmosis is summarized in Table 1 [ 12 – 15 ].…”

“…He was at higher risk for developing the infection as he was immunocompromised and on immunosuppressants for his RA. The other listed cases of miliary histoplasmosis that are listed in Table 1 involved young individuals who were not immunocompromised except for one patient with HIV [ 15 ].…”