Clinical Image
Simultaneous Miliary and Genital Tuberculosis
Tuberculosis miliar y genital simultáneas
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(D–F) PET/CT after administration of 18F-FDG. Mass in right upper lobe with large areas of necrosis and cavitation (A) with increased peripheral glucose metabolism (D). Lesion in the apex of the right ventricle (B and E, arrow) suggestive of cardiac metastasis. Image of peripheral base nodule containing air space in the right lower lobe (C, arrow) suggestive of pulmonary infarction. 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(B) Chest CT sagittal slice. (C) Pelvis CT pelvic slice.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 29-year-old woman, native of Bolivia, presented with a progressive clinical syndrome of low-grade fever, dry cough, and dyspnea on exertion. She also reported a 3-month history of abdominal pain and leukorrhea after therapeutic abortion, which had not improved despite the administration of targeted antibiotic therapy with ciprofloxacin when <span class="elsevierStyleItalic">Escherichia coli</span> was cultured from the vaginal discharge. Chest radiograph and computed tomography (CT) were performed showing extensive bilateral micronodular involvement (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B). Abdominal CT revealed tubular parauterine cystic images with fatty peripheral edema and lamina propria with free fluid consistent with salpingitis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). Mantoux testing showed no induration at all, but sputum smear and Löwenstein medium cultures of sputum samples and vaginal discharge were positive for <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The coexistence of genital and miliary tuberculosis (TB) has been previously reported.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Up to 8%–15% of women with pulmonary tuberculosis have genital TB.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> Genital TB is a known cause of sterility and abortions, as occurred in our patient. The patient probably had previous genital TB, and the curettage led to hematogenous spread, resulting in secondary miliary TB.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Montes Ruiz-Cabello M, Guirao Arrabal E, Aisa Denaroso LM. Tuberculosis miliar y genital simultáneas. Arch Bronconeumol. 2017;53:397.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 780 "Ancho" => 1040 "Tamanyo" => 123931 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Standard chest radiograph. (B) Chest CT sagittal slice. (C) Pelvis CT pelvic slice.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "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" => "en" "url" => "/15792129/0000005300000007/v1_201706290145/S1579212917301726/v1_201706290145/en/main.assets" "Apartado" => array:4 [ "identificador" => "21342" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Clinical Image" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005300000007/v1_201706290145/S1579212917301726/v1_201706290145/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212917301726?idApp=UINPBA00003Z" ]
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