24 July 2008
Pulmonary tuberculosis in an immunocompetent host with atypical radiographic findings
Husnain Syed, Kapil Rangavajhala, Vipin Garg, Marcus CabrerraAm J Case Rep 2008; 9:325-328 :: ID: 865122
Abstract
Background: Pulmonary tuberculosis (TB) is generally thought of as a disease seen in recent immigrants from endemic regions of the world or in those with chronic debilitating conditions causing significant immunosuppression. However, there is a sub-segment of the population, who are otherwise healthy, lack risk factors for TB and present with mild, protean symptoms, where a high index of suspicion for TB, requiring a thorough work up is warranted.
Case Report: The following case describes an atypical clinical presentation of pulmonary TB in an otherwise healthy, foreign born young man. Chest radiography demonstrated impressive bilateral granulomatous appearing infi ltrates and consolidations, which evoked a wide differential diagnosis. Initial work up, including PPD testing and sputum AFB were negative. Bronchoscopy was performed and after 30 days of incubation the bronchial washing culture specimen turned positive for AFB. DNA probe testing confirmed the specimen to be M. tuberculosis and appropriate treatment was instituted .
Conclusions: Atypical presentations of pulmonary TB in young, healthy, immunocompetent foreign born individuals exist. These cases can be challenging as a high index of suspicion for TB is required in the setting of mild symptomotology and atypical radiographic fi ndings. Often invasive diagnostic testing, including bronchoscopy may be needed to confi rm a diagnosis so that appropriate medical treatment can be instituted and measures taken to prevent further spread of a potentially fatal disease.
Keywords: Tuberculosis, pulmonary, immunocompetent
In Press
19 Mar 2024 : Case report
Medial Hoffa Fracture: A Case Report and Literature Review of Approach and ManagementAm J Case Rep In Press; DOI: 10.12659/AJCR.943136
21 Mar 2024 : Case report
Pediatric Neurogenic Pulmonary Edema After Brain Tumor Removal Complicated with Severe Myocardial Injury: A...Am J Case Rep In Press; DOI: 10.12659/AJCR.943645
21 Mar 2024 : Case report
Chlamydia psittaci Pneumonia: Diagnosis, Treatment, and Challenges in the Context of COVID-19Am J Case Rep In Press; DOI: 10.12659/AJCR.942921
22 Mar 2024 : Case report
Sleep Disorders and Traffic Accidents: Unveiling the Hidden RisksAm J Case Rep In Press; DOI: 10.12659/AJCR.943346
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250