Presentation
Chest discomfort and weight loss. Immunosuppressed with a background of hemophagocytic lymphohistiocytosis.
Patient Data
Extensive widespread lung nodules. No concerning osseous lesion.
Extensive small bilateral pulmonary nodules are seen with areas of air space opacification (mostly to right middle lobe).
There is hepatomegaly and gallbladder wall thickening, consistent with hemophagocytic lymphohistiocytosis.
Overall findings are in keeping with miliary infection (tuberculosis), differential includes metastases.
Day 3 of admission: increased airspace opacification with widespread distribution.
Endotracheal tube and right permacath.
Case Discussion
A case of miliary tuberculosis with imaging features of hemophagocytic lymphohistiocytosis.
This is in the setting of immunosuppression with a known background of hemophagocytic lymphohistiocytosis, and previous travel to the South Pacific Islands.
Sputum was positive for acid-fast bacilli.
The patient passed away after developing multi-organ failure due to disseminated disease.
Case courtesy of Dr. Bradley Wray.
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