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Fulminant Miliary Tuberculosis With Adult Respiratory Distress Syndrome Undiagnosed Until Autopsy: A Report of 2 Cases and Review of the Literature

Department of Pulmonary, Critical Care and Sleep Medicine, Detroit Medical Center/Wayne State University, Detroit, MI

Kasem Sirithanakul, MD

Department of Pulmonary, Critical Care and Sleep Medicine, Detroit Medical Center/Wayne State University, Detroit, MI

Jorge A. Guzman, MD

Department of Pulmonary, Critical Care and Sleep Medicine, Detroit Medical Center/Wayne State University, Detroit, MI, jguzman{at}med.wayne.edu

Despite an overall decline in the incidence of tuberculosis (TB), the percentage of cases representing miliary TB has remained stable. We report 2 cases of fatal miliary TB that remained unrecognized until autopsy, occurring within a 6-month period at 1 Detroit institution. These cases represent the wide range of presentation of miliary TB, from an acute fulminant course to a cryptic prolonged course with subtle clinical findings. Both cases shared a common end point with the development of adult respiratory distress syndrome.

Key Words: adult respiratory distress syndrome • miliary tuberculosis • cryptic miliary tuberculosis • fulminant miliary tuberculosis • fulminant hepatic failure

Journal of Intensive Care Medicine, Vol. 20, No. 6, 306-311 (2005)
DOI: 10.1177/0885066605279150


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