An unexpected finding in a man with multiple pulmonary nodules, a pleural effusion and respiratory failure.
We report the case of a 47-year old Caucasian man with a history of depression and high alcohol intake who presented with a one-month history of weight loss, dry cough and abdominal pain. He had no smoking history of note. The patient was treated for a suspected chest infection, however developed respiratory failure and was intubated. A CT showed multiple pulmonary nodules, left pleural thickening extending to the mediastinum and bilateral pleural effusions-larger on the left, suggestive of disseminated malignancy. A broncho-alveolar lavage surprisingly contained numerous acid-fast bacilli and no malignant cells. Treatment for tuberculosis was initiated and the patient recovered gradually. After several weeks, a pyrazinamide-resistant organism was cultured and subsequently identified to beMycobacterium Bovis. We discuss this unexpected finding and review the literature on Bovine Tuberculosis in humans.
Great Western Hospital, Marlborough Road, Swindon, SN3 6BB, United Kingdom.
Yik Lam
YL
Pang
Great Western Hospital, Marlborough Road, Swindon, SN3 6BB, United Kingdom.
Quentin
Q
Jones
Bovine tuberculosis; Mycobacterium Bovis; Tuberculosis