PT  - JOURNAL ARTICLE
AU  - Nawel Ben Salem
AU  - Nawel Chaouch
AU  - Manel Loukil
AU  - Mourad Zarrouk
AU  - Sana Cheikh Rouhou
AU  - Hajer Racil
AU  - Abdellatif Chabbou
TI  - Miliary tuberculosis in immunocompetent and BCG vaccinated patients
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2580
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2580.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2580.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Miliary (M) tuberculosis (TB) is a rare form of TB is in BCG vaccinated patients and occurs more frequently in immunocompromised patients. To evaluate frequency and clinical features of MTB in immunecompetent patients, we analyzed all cases of MTB diagnosed in a pulmonary department between 2000 and 2010, in patients with negative HIV test. We study 5 cases of 35 mean aged patients leading to an incidence of 2.6% among all TB patients seen in the same period. All were male, smokers and BCG vaccinated. One patient had diabetes and one had had viral C hepatitis. All had fever and poor general condition. One patient presented with acute respiratory failure. Chest x ray revealed bilateral interstitial micronodules in all cases. Tuberculin skin reaction was positive in 3 cases. Three cases were smeare positive. Medullary biopsy confirmed TB in 1 case. One case was retrospectively confirmed by good response to treatment. Extrapulmonary localization was: hepatic in 5 cases, splenic in 2 cases, lymph nodal in 1 case, cerebromeningeal, medullary,osteoarticular and renal in 1 case each. Treatment administered urgently was based on antituberculous drugs (HRZE) associated in 3 cases to corticosteroïds. Outcome was favorable in all cases. One patient died 5 months after but due to another disease.In conclusion, MTB in immunocompetent and vaccinated patients seems to be more easily confirmed with a better outcome compared to immunocompromised patients as reported in the literature, when anti TB treatment is established very early. Really, in patients with radiological M and fever TB should always evoked and treated urgently as such.