Signs of miliary tuberculosis : which diagnostic tests and when to treat?
Three patients, men aged 21, 57 and 53 years, presented with variable non-specific symptoms such as general malaise, weight loss, elevated temperature, abdominal pain, cough, pulmonary crepitations and elevated liver enzymes. Diffuse fine nodular infiltration was seen on chest radiography in the last two cases. The first patient refused to be tentatively treated with tuberculostatics and died. Mycobacterium tuberculosis complex grew on Löwenstein medium a week later. The two other patients received tuberculostatic treatment. The second patient recovered, while the third patient suffered a cerebrovascular accident on top of emaciation and respiratory insufficiency and died. In the Netherlands, currently more than one hundred patients with tuberculosis disease die each year. The disease is mostly seen in people from the high-risk groups for tuberculosis such as asylum seekers and immigrants. Even after extensive diagnostic procedures it can be difficult to obtain rapid bacteriological confirmation. When miliary tuberculosis is suspected it is important to carry out the complete range of tests (Ziehl Neelsen microscopy, PCR, Löwenstein cultivation) and to start therapy immediately and not to await the results of the diagnostic tests. However, in many cases this may still be too late, with an estimated mortality of 20%.
| Errataetall: |
CommentIn: Ned Tijdschr Geneeskd. 2002 Jun 22;146(25):1165-8. - PMID 12109305 |
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| Medienart: |
Artikel |
| Erscheinungsjahr: |
2002 |
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| Erschienen: |
2002 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:146 |
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| Enthalten in: |
Nederlands tijdschrift voor geneeskunde - 146(2002), 25 vom: 22. Juni, Seite 1161-5 |
| Sprache: |
Niederländisch |
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| Weiterer Titel: |
Aanwijzingen voor miliaire tuberclose: welke diagnostiek en wanneer behandelen? |
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| Beteiligte Personen: |
Verhave, J C [VerfasserIn] |
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| Themen: |
Antitubercular Agents |
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| Anmerkungen: |
Date Completed 26.09.2002 Date Revised 15.11.2006 published: Print CommentIn: Ned Tijdschr Geneeskd. 2002 Jun 22;146(25):1165-8. - PMID 12109305 Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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NLM119784254 |
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| 245 | 1 | 0 | |a Signs of miliary tuberculosis |b which diagnostic tests and when to treat? |
| 246 | 3 | 3 | |a Aanwijzingen voor miliaire tuberclose: welke diagnostiek en wanneer behandelen? |
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| 500 | |a CommentIn: Ned Tijdschr Geneeskd. 2002 Jun 22;146(25):1165-8. - PMID 12109305 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Three patients, men aged 21, 57 and 53 years, presented with variable non-specific symptoms such as general malaise, weight loss, elevated temperature, abdominal pain, cough, pulmonary crepitations and elevated liver enzymes. Diffuse fine nodular infiltration was seen on chest radiography in the last two cases. The first patient refused to be tentatively treated with tuberculostatics and died. Mycobacterium tuberculosis complex grew on Löwenstein medium a week later. The two other patients received tuberculostatic treatment. The second patient recovered, while the third patient suffered a cerebrovascular accident on top of emaciation and respiratory insufficiency and died. In the Netherlands, currently more than one hundred patients with tuberculosis disease die each year. The disease is mostly seen in people from the high-risk groups for tuberculosis such as asylum seekers and immigrants. Even after extensive diagnostic procedures it can be difficult to obtain rapid bacteriological confirmation. When miliary tuberculosis is suspected it is important to carry out the complete range of tests (Ziehl Neelsen microscopy, PCR, Löwenstein cultivation) and to start therapy immediately and not to await the results of the diagnostic tests. However, in many cases this may still be too late, with an estimated mortality of 20% | ||
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| 700 | 1 | |a van Altena, R |e verfasserin |4 aut | |
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