ABSTRACT
An immigrant from India presented with a three months history of fever, weight loss, cough and hepatomegaly which were rapidly diagnosed as miliary tuberculosis when gastric lavage revealed acid-fast bacilli. One day after antituberculous therapy was commenced, the patient developed adult respiratory distress syndrome and disseminated intravascular coagulation which were successfully treated by corticosteroids, fresh frozen plasma and mechanical ventilation. Ten other survivors of miliary tuberculosis and adult respiratory distress syndrome were reviewed and the association of adult respiratory distress syndrome with the antimicrobial therapy is discussed.
Subject(s)
Respiratory Distress Syndrome/etiology , Tuberculosis, Miliary/complications , Anti-Bacterial Agents , Drug Therapy, Combination/therapeutic use , Humans , Male , Methylprednisolone/therapeutic use , Middle Aged , Ranitidine/therapeutic use , Respiration, Artificial , Respiratory Distress Syndrome/therapy , Tuberculosis, Miliary/drug therapyABSTRACT
A young man who presented with a 3 week history of fever and severe headache accompanied by mild leukocytosis, was found to have lymphocytic meningitis due to Coxiella burnetti. Thus, Q fever can present as lymphocytic (aseptic) meningitis responsive to tetracycline with no evidence of pulmonary involvement.
