Miliary tuberculosis of the liver as a cause of septic shock with multi-organ failure

A woman aged 63 presented with septic fever, followed by hepatocellular jaundice. Viral hepatitis was ruled out by serologic tests, but no definite diagnosis could be made. Due to severe disturbance of the plasmatic coagulatory system and a serum bilirubin level above 4 mg/dl, a liver biopsy was not...

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Bibliographic Details
Published inWiener Klinische Wochenschrift Vol. 106; no. 4; p. 111
Main Authors Mandak, M, Kerbl, U, Kleinert, R, Höfler, G, Zeichen, R, Denk, H
Format Journal Article
LanguageGerman
Published Austria 1994
Subjects
Diagnosis, Differential
DNA, Bacterial - analysis
Female
Humans
Liver - pathology
Middle Aged
Multiple Organ Failure - etiology
Multiple Organ Failure - pathology
Mycobacterium tuberculosis - genetics
Mycobacterium tuberculosis - isolation & purification
Polymerase Chain Reaction
Shock, Septic - etiology
Shock, Septic - pathology
Tuberculosis, Hepatic - complications
Tuberculosis, Hepatic - pathology
Tuberculosis, Miliary - complications
Tuberculosis, Miliary - pathology
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Summary:A woman aged 63 presented with septic fever, followed by hepatocellular jaundice. Viral hepatitis was ruled out by serologic tests, but no definite diagnosis could be made. Due to severe disturbance of the plasmatic coagulatory system and a serum bilirubin level above 4 mg/dl, a liver biopsy was not performed. The patient had a persistent septicemia refractory to Imipenem. In spite of intensive care measures, the patient died of disseminated intravascular coagulation and multiorgan failure caused by septic shock. The correct diagnosis of miliary tuberculosis was made only post mortem by histopathological examination of liver specimens and confirmed by detection of Mycobacterium tuberculosis DNA in the patient's liver by polymerase chain reaction.
ISSN:0043-5325