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Abstract

Most tuberculosis (TB) infections in women of reproductive age occur around pregnancy and the postpartum period. Miliary TB is a disseminated form of the disease which is rare during pregnancy and postpartum but potentially fatal. The clinical presentation of miliary pulmonary TB is not specific and body specimens may be difficult to obtain or give a negative finding, leading to delayed diagnosis and treatment. The decision to investigate patients’ symptoms with imaging can be rewarding as the miliary pattern can be easily recognized. We report a case of postpartum miliary pulmonary TB in a client negative for human immunodeficiency virus infection that was diagnosed with chest computed tomography after prolonged illness and no certain clinical diagnosis.


RÉSUMÉ 


L’atteinte pulmonaire de la tuberculose est plus fréquemment rencontrée durant la grossesse et la période de post-partum chez la femme en âge de procréer. La forme miliaire est beaucoup moins courante, mais plus létale, vu son caractère disséminé, affectant plusieurs organes simultanément. La présentation clinique de la tuberculose pulmonaire miliaire pendant la grossesse est souvent masquée, voire confondue, avec les symptômes constitutionnels de la grossesse. La confirmation au laboratoire est souvent négative, en raison de l’obtention difficile des prélèvements biologiques, avec pour conséquent des retards significatif de diagnostic et de traitement. Ce délai de temps peut être raccourci, grâce au recours à l’imagerie médicale dans l’investigation des symptômes constitutionnels non spécifiques de la maladie. Ce qui permettra d’orienter vers une étiologie, et d’identifier l’aspect lésionnel micronodulaire disséminé, quasi-pathognomonique de la tuberculose pulmonaire miliaire. Afin d’alerter les cliniciens devant des difficultés diagnostiques, avec pour but de leur donner des outils diagnostics, nous rapportons un cas de tuberculose pulmonaire miliaire en post-partum chez une patiente négative à l’infection due au virus d’immunodéficience humaine, gravement malade, et sans diagnostic clinique certain.

Article Details

How to Cite
admin, admin, TAMBE Joshua, SIMO WAMBO André, ONANA Yannick, & ZEH Odile Fernande. (2021). Diagnostic challenges and the role of medical imaging in postpartum miliary tuberculosis. Journal Africain d’Imagerie Médicale (J Afr Imag Méd)., 13(1). https://doi.org/10.1001/jaim.v13i1.187

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