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首页> 外文期刊>Sao Paulo Medical Journal >Miliary tuberculosis with positive acid-fast bacilli in a pediatric patient
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Miliary tuberculosis with positive acid-fast bacilli in a pediatric patient

机译：儿科患者的粟粒性结核伴抗酸菌

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CONTEXT: Tuberculosis is an important public health issue. The Brazilian government reported 78,460 new cases in 1999. Miliary tuberculosis is a severe form of this disease. OBJECTIVE: To report on an uncommon clinical presentation of miliary tuberculosis in a child. CASE REPORT: A 5-year old boy presented in the emergency room with fatigue and weight loss. He had had Staphylococcus aureus pneumonia 7 months before. Chest radiography revealed lobar consolidation and miliary pattern associated with small cavities in both upper lobes. Antibiotic therapy was started. The sputum was positive for acid-fast bacilli and hence the treatment recommended for tuberculosis (rifampicin, isoniazid [INH], pyrazinamide) was started. The patient was treated for 9 months and at the end of the follow-up period he had made a complete clinical recovery. CONCLUSION: Although in some particular cases sputum can be positive for acid-fast bacilli in children, limitations to the sputum test have forced pediatricians to base tuberculosis diagnosis on epidemiological data, clinical findings and radiographic pattern. In this particular case, we hypothesize that the sputum bacillus test was positive because bacilli grew inside residual pneumatoceles that were produced during previous pneumonia.
机译：背景：结核病是重要的公共卫生问题。巴西政府在1999年报告了78,460例新病例。粟粒性结核是该病的严重形式。目的：报道儿童粟粒性结核的罕见临床表现。病例报告：一个5岁男孩在急诊室出现疲劳和体重减轻。他在7个月前患有金黄色葡萄球菌肺炎。胸部X线片检查显示，大叶巩固和粟粒型与两个上叶小腔相关。开始抗生素治疗。痰对耐酸杆菌呈阳性，因此开始推荐用于结核病的治疗（利福平，异烟肼[INH]，吡嗪酰胺）。该患者接受了9个月的治疗，在随访期结束时他已完全康复。结论：尽管在某些特殊情况下痰液对儿童的抗酸杆菌呈阳性，但由于痰液检测的局限性，儿科医生不得不根据流行病学数据，临床表现和放射影像学方法对结核病进行诊断。在这种特殊情况下，我们假设痰杆菌测试为阳性，因为细菌生长在先前肺炎期间产生的残留肺气肿内。

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