title: [A case of miliary tuberculosis presenting as fever and jaundice with hepatic failure looking like the course of fulminant hepatitis].
abstract: A 79-year-old male was admitted to the Metropolitan Hiroo Hospital with chief complaints of icterus and fever. A few weeks prior to admission, he developed fever and swelling of right side of the neck and was seen at a local hospital where an anti-inflammatory agent was prescribed. The fever subsided in a few days, but recurred together with development of icterus a few weeks later, precipitating this hospitalization. After admission, hepatic failure progressed rapidly, indicating a fulminant hepatitis. Renal failure also developed and he died. Autopsy revealed diffuse caseous necrosis with demonstration of acid-fast bacilli in the liver, as did in the spleen, kidney and bone marrow. This case epitomizes a subset of miliary tuberculosis in which the hepatic failure predominates the clinical presentation while lacking the ante-mortem chest X-ray features suggestive of pulmonary tuberculosis and post-mortem macroscopic changes indicative of tuberculosis.
authors.affiliation: Department of Internal Medicine, Tokyo Saiseikai Central Hospital.
authors.forename: K
authors.initials: K
authors.lastname: Hosokawa
authors.forename: A
authors.initials: A
authors.lastname: Morita
authors.forename: T
authors.initials: T
authors.lastname: Imai
authors.forename: M
authors.initials: M
authors.lastname: Kitahara
authors.forename: K
authors.initials: K
authors.lastname: Kamegaya
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Kawahara
mesh_terms: D000368:Aged; D005334:Fever / Q000209:etiology; D006505:Hepatitis / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D007565:Jaundice / Q000209:etiology; D008099:Liver / Q000382:microbiology / Q000473:pathology; D017093:Liver Failure / Q000209:etiology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014391:Tuberculosis, Miliary / Q000150:complications*