https://doi.org/10.4081/cdr.12.12637

Crazy nodules in a hazy field: miliary tuberculosis presenting with ground glass opacities in a diagnosed case of Henoch–Schönlein purpura

Vol. 12 (2024): Early Access
Submitted: 6 May 2024
Accepted: 26 June 2024
Published: 21 August 2024
Miliary tuberculosis, ground glass opacities, Henoch–Schönlein purpura, atypical radiology
Abstract Views: 158
PDF: 27
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Dhilnaz A. S.
dilz.saj@gmail.com
https://orcid.org/0009-0005-0032-1474
Department of Pulmonary, Critical Care and Sleep Medicine, Government Medical College and Hospital, Chandigarh, India.
Komaldeep Kaur
Department of Pulmonary, Critical Care and Sleep Medicine, Government Medical College and Hospital, Chandigarh, India.
Aamir Shokat
Department of Pulmonary, Critical Care and Sleep Medicine, Government Medical College and Hospital, Chandigarh, India.
Mandeep Kaur Sodhi
Department of Pulmonary, Critical Care and Sleep Medicine, Government Medical College and Hospital, Chandigarh, India.
Sakshi Boora
Department of Pulmonary, Critical Care and Sleep Medicine, Government Medical College and Hospital, Chandigarh, India.
Chahat Bhatia
Department of Pulmonary, Critical Care and Sleep Medicine, Government Medical College and Hospital, Chandigarh, India.
Varinder Saini
Department of Pulmonary, Critical Care and Sleep Medicine, Government Medical College and Hospital, Chandigarh, India.

Tuberculosis is known for its atypical manifestations among the immunosuppressed. In this case report, we describe a rare radiological presentation of tuberculosis in a patient on treatment with steroids for Henoch–Schönlein Purpura (HSP). The patient presented with complaints of fever, dry cough, and breathlessness. Chest imaging revealed diffuse ground glass opacity in bilateral lung fields with innumerable random nodules and mediastinal lymphadenopathy. Fundus examination revealed choroid tubercles and was diagnosed as miliary tuberculosis. The patient was started on anti-tubercular therapy and the patient improved symptomatically. This case report necessitates clinicians to keep an eye open for the atypical manifestations of tuberculosis.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
World Health Organization (WHO). WHO global tuberculosis report 2022. 2023. Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022
Sharma SK, Mohan A, Sharma A, Mitra DK. Miliary tuberculosis: new insights into an old disease. Lancet Infect Dis. 2005;5:415-30.
Pillebout E, Thervet E, Hill G, et al. Henoch-Schönlein purpura in adults. Outcome and prognostic factors. J Am Soc Nephrol. 2002;13:1271-8.
Nadrous HF, Yu AC, Specks U, Ryu JH. Pulmonary involvement in Henoch-Schönlein purpura. Mayo Clin Proc. 2004;79:1151-7.
Han BG, Choi SO, Shin SJ, et al. A case of Henoch-Schönlein purpura in disseminated tuberculosis. Korean J Intern Med. 1995;1:54-9.
Mishima Y, Takeuchi M, Kamisaka K, et al. Henoch-Schönlein purpura associated with pulmonary tuberculosis. Kekkaku. 1994;69:21-5.
Pacheco A. Henoch-Schönlein vasculitis and tuberculosis. Chest. 1991;100:293-4.
Chan CHS, Chong YW, Sum AJM, Hoheisel GB. Cutaneous vasculitis with tuberculosis and its treatment. Tubercle. 1990;71:297-300.
Islek I, Muslu A, Totan M, Gok F, et al. Henoch-Schönlein purpura and pulmonary tuberculosis. Pediatr Int. 2002;44:545-6.
Kitamura H, Shimizu K, Takeda H, et al. A case of Henoch-Schönlein purpura nephritis in pulmonary tuberculosis. Am J Med Sci. 2007;333:117-21.
Isobe Z, Suga T, Aoki Y, et al. A case of anaphylactoid purpura associated with nephrosis followed by pulmonary tuberculosis. Nihon Kokyuki Gakkai Zasshi. 2008;46:645-9.
El-Sherief AH, Gilman MD, Healey TT. Clear vision through the haze: a practical approach to ground-glass opacity. Curr Probl Diagn Radiol. 2014;43:140-5.
Lee J, Lim JK, Seo H, et al. Clinical relevance of ground glass opacity in 105 patients with miliary tuberculosis. Resp Med. 2014;108:924-30.
Kim JY, Jeong YJ, Kim KI, et al. Miliary tuberculosis: a comparison of CT findings in HIV-seropositive and HIV-seronegative patients. Brit J Radiol 2010;83:206-11.
Hong SH, Im JG, Lee JS, et al. High resolution CT findings of miliary tuberculosis. J Comput Assist Tomogr. 1998;22:220-4.
Choi D, Lee K S, Suh G Y, et al. Pulmonary tuberculosis presenting as acute respiratory failure: radiologic findings. J Comput Assist Tomogr. 1999;23:107-13.

How to Cite

A. S., D., Kaur, K., Shokat, A., Kaur Sodhi, M., Boora, S., Bhatia, C., & Saini, V. (2024). Crazy nodules in a hazy field: miliary tuberculosis presenting with ground glass opacities in a diagnosed case of Henoch–Schönlein purpura. Chest Disease Reports, 12(1). https://doi.org/10.4081/cdr.12.12637
Copyright (c) 2024 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.