Poncet disease in a patient with smear-negative pulmonary tuberculosis: A case report

High-resolution computed tomography (HRCT) of the thorax was planned, and it showed multiple solid, ground glass and part-solid nodules in the bilateral lungs. The patients condition was then treated as smear-negative pulmonary tuberculosis with a standard antituberculosis regimen involving a 2-mont...

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Published inMalaysian family physician Vol. 19; pp. 1 - 5
Main Authors Ooi, Poh Siang, Ismail, Harfini, Meganathan, Gayatherri, Saidi, Nurfathehatul Nabila, Dhamotharan, Yeogeashweary, Chua, Hui Heng
Format Journal Article
LanguageEnglish
Published Kuala Lumpur Academy of Family Physicians of Malaysia 01.01.2024
Subjects
Acids
Antibiotics
Antibodies
COVID-19
Disease transmission
Erythema
Fever
Infections
Lavage
Lungs
Pain
Patients
Radiography
Rheumatoid arthritis
Rheumatology
Skin
Tuberculosis
Viral infections
Wrist
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Summary:High-resolution computed tomography (HRCT) of the thorax was planned, and it showed multiple solid, ground glass and part-solid nodules in the bilateral lungs. The patients condition was then treated as smear-negative pulmonary tuberculosis with a standard antituberculosis regimen involving a 2-month intensive phase with isoniazid, rifampicin, pyrazinamide and ethambutol, followed by a 4-month maintenance phase with isoniazid and rifampicin. The symptoms of smear-positive and smear-negative pulmonary tuberculosis can be similar.3 A retrospective study found that the absence of cough and the absence of a radiographic pattern typical of tuberculosis were associated with smear-negative tuberculosis.4 In the present case, the diagnosis of pulmonary tuberculosis was delayed because Madam R presented only with weight loss, a transient history of fever and negative acid-fast bacillus sputum smears. The algorithm for diagnosing smear-negative pulmonary tuberculosis developed by the World Health Organization in 2003 requires at least three negative sputum smears, chest radiography findings consistent with tuberculosis and a lack of response to a trial of broad-spectrum antimicrobial agents.5 Two sputum samples from Madam R obtained via direct sputum collection and one sample via bronchoalveolar lavage were negative.
ISSN:1985-2274
1985-2274