multivisceral tuberculosis

COVID-19 is a viral infection with predominant respiratory tropism. In its most severe forms, the initial viral aggression leads to acute respiratory failure due to damage secondary to an exacerbated inflammatory response provoked by the activation of innate, followed by adaptive immunity. The inflammatory response may entail respiratory distress syndrome, if not multivisceral failure and death. IL-6 receptor inhibitors (Tocilizumab and Sarilumab) have been proposed as treatments. Numerous studies have provided new information, which remains heterogeneous and difficult to interpret...

The medical and imaging data of a 59 year old male is reported. The patient presented with cough, fever, night sweats and weight loss, for which a final diagnosis of multivisceral tuberculosis (with peritoneal involvement and mycotic aneurysm) was made, by means of CT, MRI and laparoscopic findings. This disease is uncommon in developed countries with subjects lacking the usual risk factors. Because delayed treatment may be lethal, especially with such serious vascular complication, the authors review the value and limitations of CT and MRI along with the suggestive features...

An 81-year-old man, with a history of pulmonary tuberculosis presented with coma after coughing associated to haemoptysis. The CT-scan revealed several scattered gas bubbles, while the thoracic scan disclosed an old tubercular parenchymatous cave. In spite of several sessions of hyperbaric oxygen treatment, the patient died with multivisceral organ failure. This case report reviews the pathophysiology of gas embolism due to coughing.

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INTRODUCTION: Infection with Histoplasma capsulatum (Hc) is a rare importing disease in metropolitan France, the most often minor but sometimes letal in its spread form. EXEGESIS: A 58 years old French man, HIV seronegative, was admitted for an alteration of its general condition, disorder and buccal ulcerations. He had a prostate cancer history and came back in France after 17 years in Central Africa. The imaging showed numerous cerebral nodes, a bilateral adrenal tumor, and pulmonary calcifications...

BACKGROUND: Neonatal and/or congenital tuberculosis is insufficiently understood. CASE REPORTS: Case 1. A premature hypotrophic neonate presented at the age of 45 days, without any maternal contact, a bilateral bronchopneumopathy. Whilst the pregnancy and birth had not been affected by any noteworthy problem, the mother died from miliary tuberculosis despite rifampin, isoniazid and pyrazinamide treatment. Her baby also died on day 52 from multivisceral failure. Culture of tracheal secretions confirmed a few weeks later the diagnosis of tuberculosis...

A case of a middle-aged African-American woman with weight loss, ascites, a bilateral pleural effusion with no infiltrate, and a clinical diagnosis of a metastatic gynecological tumor is presented. Her carcinoembryonic antigen (CEA) and CA-125 levels were elevated (400 micrograms/L and 331 micrograms/L, respectively). She underwent an exploratory laparotomy and a dilation & curettage for biopsies and cultures. Pathological examination showed Langhans' type giant cells on peritoneal biopsy. An endometrial curette biopsy showed granulomatous endometritis and acid-fast bacilli...

The case reported here concerns a 30-year old male patient who had both very severe, multivisceral tuberculosis and equally severe sarcoidosis, with repercussions on the respiratory function that required corticosteroid therapy. Prolonged anti-tuberculous therapy and corticosteroids gave favourable results. This case is remindful of an old debate which opposed the two diseases on account of their histological lesions. It offers a new example of the severity of tuberculosis in "immunocompromised" patients, and it raises anew the still unresolved problem of the individuality of sarcoidosis in pulmonary pathology...

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