A Case of Miliary Tuberculosis Confirmed via Repeated Chest Computed Tomography and Interferon-γ Release Assay

抄録

A febrile 27-year-old male patient with lymphadenopathies was admitted to our hospital. Tuberculosis was considered as one of the differential diagnoses. Lung lesions were not apparent by the first chest computed tomography, and the result of T-SPOT®.TB was negative. A secondary chest computed tomography, however, showed a miliary pattern shadow in images of the bilateral lungs, and a QuantiFERON®-TB Gold Plus test was positive. In addition, an acid-fast bacillus was detected in the patient’s gastric lavage, and a collection of epithelioid cells was revealed in a trans-bronchial lung biopsied specimen. We finally confirmed the patient’ s diagnosis as miliary tuberculosis. Clinicians should be aware that tuberculosis cases often require difficult diagnostic processes with vigorous support from many specialists.