title: [Miliary tuberculosis of the liver as a cause of septic shock with multi-organ failure].
abstract: A woman aged 63 presented with septic fever, followed by hepatocellular jaundice. Viral hepatitis was ruled out by serologic tests, but no definite diagnosis could be made. Due to severe disturbance of the plasmatic coagulatory system and a serum bilirubin level above 4 mg/dl, a liver biopsy was not performed. The patient had a persistent septicemia refractory to Imipenem. In spite of intensive care measures, the patient died of disseminated intravascular coagulation and multiorgan failure caused by septic shock. The correct diagnosis of miliary tuberculosis was made only post mortem by histopathological examination of liver specimens and confirmed by detection of Mycobacterium tuberculosis DNA in the patient's liver by polymerase chain reaction.
authors.affiliation: Interne Abteilung, Landeskrankenhaus Hörgas, Gratwein.
authors.forename: M
authors.initials: M
authors.lastname: Mandak
authors.forename: U
authors.initials: U
authors.lastname: Kerbl
authors.forename: R
authors.initials: R
authors.lastname: Kleinert
authors.forename: G
authors.initials: G
authors.lastname: Höfler
authors.forename: R
authors.initials: R
authors.lastname: Zeichen
authors.forename: H
authors.initials: H
authors.lastname: Denk
mesh_terms: D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology* / Q000473:pathology; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D012772:Shock, Septic / Q000209:etiology* / Q000473:pathology; D014386:Tuberculosis, Hepatic / Q000150:complications* / Q000473:pathology; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000473:pathology
chemical_list: D004269:DNA, Bacterial
vernacular_title: Miliare Tuberkulose der Leber als Ursache eines septischen Schocks mit Multiorganversagen.