A CASE OF MILIARY TUBERCULOSIS DIAGNOSED BY AUTOPSY

Abstract

An 83-year-old female with liver cirrhosis was admitted to our hospital because of high fever. Miliary tuberculosis was highly suspected and antituberculous drugs were administered. Fever continued and diffuse miliary shadows appeared on a chest X-ray film and slowly progressed. A transbronchial lung biopsy and prescalenenode biopsy were performed but they were not diagnostic. She was complicated by hepatic dysfunction, which was considered drug-induced type, and antituberculous drugs were discontinued. Then acute respiratory failure occurred twice and steroid therapy was effective.
Consequently 6 months after admission she died from bleeding tendency. Autopsy revealed miliary tuberculosis and diffuse lung fibrosis. Premortem diagnosis was difficult in this case.