More compatible with 'cryptic miliary tuberculosis'

Abstract

More compatible with 'cryptic miliary tuberculosis' To the Editor-I read with interest the case report published by Shea and Ip titled "Pulmonary tuberculosis complicating asbestosis". 1 On reading the details, I could not agree on the authors' interpretation of the findings and the diagnosis of asbestosis. While it is beyond doubt that the findings of calcified pleural plaques point towards the diagnosis of a form of "asbestos-related pleural disease", this condition has to be distinguished from 'asbestosis' although the two conditions may coexist in some patients. Asbestosis refers to scarring of the lung parenchyma as a result of heavy asbestos exposure. Radiological features are usually in the form of reticulation, linear and curvilinear opacities, and parenchymal bands. 2 These features were not obvious in the computed tomographic images shown. Rather, the prominent radiological findings were those of fine nodules which, in my view, were more compatible with a diagnosis of 'cryptic miliary tuberculosis'. Cryptic miliary tuberculosis is a form of tuberculosis which tends to occur in the elderly and presents with fever of unknown origin with negative bacteriological findings. 3 Diagnosis is difficult and often delayed. Given the clinical and radiological features of the case reported here, I think a more appropriate title would be "Cryptic miliary tuberculosis in an elderly patient with underlying asbestos-related pleural plaques".

Safety Evaluation of Antituberculosis Drugs During Pregnancy: A Systematic Review and Meta-Analysis

“…In addition, isoniazid can excessively bind cellular proteins in the metabolism of hepatocytes, causing liver cell degeneration or necrosis, forming drug-induced hepatitis, which manifests as abnormal increase in ALT, AST, total bilirubin, and other indicators ( 21 ). Gastrointestinal reactions, rashes, visual disturbances, and hyperuricemic reactions caused by anti-TB drugs are also commonly reported ( 22 ).…”