Miliary tuberculosis in a young Caucasian adult.
A young Caucasian adult presented to the Accident and Emergency department with small bowel obstruction, which necessitated an exploratory laparotomy. Multiple firm nodules were found with biopsies leading to a diagnosis of peritoneal tuberculosis (TB). Retrospectively, the patient was noted to have classical radiological pulmonary TB findings on a chest radiograph 3 months previously, and 2 weeks later had developed bony infiltration, paravertebral abscesses and likely TB skin lesions. This case illustrates an unusual presentation in a patient with minimal risk factors yet widespread extra-pulmonary disease. It also highlights the importance of attentive reviewing of x-rays.
St George's NHS Trust, London, UK. shsafavi@doctors.org.uk
Shahideh
S
Safavi
Benjamin
B
Colaluca
Kumuthan
K
Sriskandarajah
D000328:Adult; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011859:Radiography; D014391:Tuberculosis, Miliary / Q000175:diagnosis* / Q000208:ethnology; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000208:ethnology; D044465:White People