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Tuberculosis miliar y genital simultáneas
Simultaneous Miliary and Genital Tuberculosis
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B) Corte axial de la TAC de tórax. C) Corte axial de la TAC de pelvis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 29 años natural de Bolivia que presentaba un cuadro progresivo de febrícula, tos seca y disnea de esfuerzo, refiriendo además en los últimos 3 meses, tras aborto terapéutico, dolor abdominal y leucorrea que no había mejorado pese a antibioterapia dirigida con ciprofloxacino por cultivo de exudado vaginal positivo para <span class="elsevierStyleItalic">Escherichia coli</span>. Se realizaron radiografía y TAC de tórax donde se observaba una afectación micronodulillar extensa bilateral (<a class="elsevierStyleCrossRef" href="#fig0005">figs. 1</a>A y B), TAC de abdomen que evidenció imágenes quísticas tubulares parauterinas con edema de grasa periférica y lámina de líquido libre compatibles con salpingitis (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>C), Mantoux que no generó induración alguna y baciloscopia y cultivos en medio de Löwenstein de muestras de esputo y exudado vaginal, en los cuales creció <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La coexistencia de tuberculosis (TB) genital y miliar ya ha sido establecida previamente<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>. Hasta un 8-15% de mujeres con TB pulmonar tienen TB genital<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>. La TB genital es una causa conocida de esterilidad y abortos tal y como ocurría en nuestra paciente. Es probable que la paciente tuviera una TB genital previa y que la realización del legrado ocasionara una siembra hematógena con TB miliar secundaria.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 780 "Ancho" => 1040 "Tamanyo" => 123406 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Radiografía simple de tórax. B) Corte axial de la TAC de tórax. C) Corte axial de la TAC de pelvis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fiebre de origen desconocido en una gestante de 13 semanas No disponible" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. Alfaro" 1 => "R. Luque" 2 => "M.L. Miranda" 3 => "R. Terrones" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2016" "volumen" => "26" "paginaInicial" => "473" "paginaFinal" => "474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18842243" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Female genital tuberculosis: A review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I.K. Neonakis" 1 => "D.A. Spandidos" 2 => "E. Petinaki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/00365548.2011.568523" "Revista" => array:6 [ "tituloSerie" => "Scand J Infect Dis" "fecha" => "2011" "volumen" => "43" "paginaInicial" => "564" "paginaFinal" => "572" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21438789" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005300000007/v2_201706291228/S0300289617300108/v2_201706291228/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005300000007/v2_201706291228/S0300289617300108/v2_201706291228/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289617300108?idApp=UINPBA00003Z" ]
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