[Miliary tuberculosis with atypical radiographic findings after aorto-coronary bypass surgery].

Abstract

Dry cough and exertional dyspnea developed in a 78-year-old man after aorto-coronary bypass surgery for angina pectoris. Chest X-ray films showed small nodular shadows in the upper and middle fields of both lungs. The patient's condition was exacerbated despite treatment with antibiotics. Chest high-resolution computed tomography disclosed small nodular and reticulo-linear shadows predominantly in the interlobular septa and bronchovascular bundles. Transbronchial lung biopsy specimens revealed micro-granulomas with necrosis, suggesting miliary tuberculosis. Antituberculosis drugs were started and the patient's symptoms and radiographic findings gradually resolved. Cases of cellular immunosuppression have beer reported in patients following open-heart surgery that utilized antifical heart and lung apparatus. Such procedures, together with hemodialysis, deserve consideration as potential risk factors for miliary tuberculosis.

• Authors: T Endo, T Saito, M Nakayama, H Ohse, S Watanabe, S Tamai, S Hasegawa
• Journal: Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society (Nihon Kokyuki Gakkai Zasshi) Vol. 37 Issue 6 Pg. 499-503 (Jun 1999) ISSN: 1343-3490 [Print] Japan
• PMID: 10434552 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Angina Pectoris (surgery)
• Coronary Artery Bypass (adverse effects)
• Humans
• Male
• Radiography
• Tuberculosis, Miliary (diagnostic imaging)