Active tuberculosis in a patient with Hodgkin's disease. A case report

We report a case of active tuberculosis in a patient with Hodgkin's disease. The two diagnoses were established simultaneously at the Respiratory Disease Unit of the Yalgado National Hospital, Burkina Faso. The clinical presentation was misleading as the signs and symptoms of the two disease are similar. Certain diagnosis was established after isolation of tuberculosis bacilli and histocytology findings for Hodgkin's disease. Both diseases are potentially curable. The clinical course depends on early diagnosis and treatment.     

Miliary tuberculosis. Report of 4 cases proved by autopsy

Four cases of acute miliary tuberculosis, including one case of nonreactive tuberculosis, are reported in this article. Final diagnoses were proved by autopsy. Literature review shows that symptoms of the disease vary greatly in different cases, but fever with unknown causes and overwhelming infection is the constant features. Nonreactive tuberculosis is common in the patients with low immunity and correct diagnosis depends on autopsy in most cases. Anti-tuberculosis drugs for nonreactive tuberculosis is not very effective and the prognosis is unfavourable. This article provides for the doctors with the experience of mis-diagnosis of acute miliary tuberculosis, especially nonreactive tuberculosis.     

Miliary tuberculosis following infliximab therapy for Crohn disease: A case report and review of the literature

We present a case of miliary tuberculosis diagnosed 15 months after infliximab treatment despite negative screening for previous exposure to Mycobacteria on skin PPD and chest X-ray. This case shows that--although screening for TB with a skin PPD and a chest X-ray should be performed in all patients--this is not 100% effective and may be a problem in patients on concomitant immunosuppression. The clinical course of this patient further shows that in a patient treated with anti-TNF antibodies who's condition does not improve one should always be aware of the possibility of a tuberculosis infection. Even though tuberculosis is usually not rapidly fatal, the disease may show a fulminant course in immunocompromised patients.     

Troglitazone-induced fulminant hepatitis: report of a case with autopsy findings

Troglitazone is an insulin-sensitizing agent used to treat type 2 diabetes mellitus. Several cases have been reported of troglitazone-induced hepatic injury; some requiring transplantation, others resulting in death. We here present a case of troglitazone-induced fulminant hepatic necrosis that led to the death of the patient.     

Miliary tuberculosis with atypical radiographic findings after aorto-coronary bypass surgery]

Dry cough and exertional dyspnea developed in a 78-year-old man after aorto-coronary bypass surgery for angina pectoris. Chest X-ray films showed small nodular shadows in the upper and middle fields of both lungs. The patient's condition was exacerbated despite treatment with antibiotics. Chest high-resolution computed tomography disclosed small nodular and reticulo-linear shadows predominantly in the interlobular septa and bronchovascular bundles. Transbronchial lung biopsy specimens revealed micro-granulomas with necrosis, suggesting miliary tuberculosis. Antituberculosis drugs were started and the patient's symptoms and radiographic findings gradually resolved. Cases of cellular immunosuppression have beer reported in patients following open-heart surgery that utilized antifical heart and lung apparatus. Such procedures, together with hemodialysis, deserve consideration as potential risk factors for miliary tuberculosis.