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Tuberculose miliar : um caso de sucesso
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Resumo(s)
A tuberculose (TB) situa-se entre as 10 principais causas de morte a nível mundial e a principal causa de morte por um único agente infecioso. Em 2017 registaram-se cerca de 1,3 milhões de mortes por TB em indivíduos não infetados por vírus da imunodeficiência humana (VIH) e 300,000 mortes em infetados por VIH. De acordo com o estudo “Global Burden of Disease”, a TB apresenta-se como uma das maiores causas de anos de vida perdidos e de anos de vida com incapacidade.
É uma doença infeciosa causada por Mycobacterium tuberculosis (Mtb). Afeta, normalmente, os pulmões (TB pulmonar), mas pode afetar também outros órgãos (TB extrapulmonar). No caso da TB miliar, ocorre a disseminação hematogénica da micobactéria levando à formação de lesões secundárias em vários órgãos.
Este trabalho tem como objetivo a análise de um caso real de TB miliar, bem como a revisão da literatura existente, relativa ao tema, e a discussão da sua apresentação clínica, revendo as características principais desta patologia. O seguimento clínico, incluindo o diagnóstico e os exames complementares de diagnóstico realizados serão apresentados e discutidos. Procura-se realçar a dificuldade diagnóstica desta patologia em indivíduos jovens pela sintomatologia, muitas vezes, inespecífica e repercussões clínicas e as suas complicações associadas.
Tuberculosis (TB) is among the 10 leading causes of death worldwide and the leading cause of death by a single infectious agent. In 2017 there were about 1,3 million TB deaths in individuals not infected with Human Immunodeficiency Virus (HIV) and 300,000 deaths in HIV-infected individuals. According to the Global Burden of Disease study, TB is one of the biggest causes of lost years of life and years of life with disability. It is an infectious disease caused by Mycobacterium tuberculosis (Mtb). It usually affects the lungs (pulmonary TB), but it can also affect other organs (extrapulmonary TB). In the case of Miliar TB, hematogenous dissemination of the mycobacterium occurs leading to the formation of secondary lesions in various organs. This work aims at the analysis of a real case of miliar TB as well as a review of the existing literature on the subject and the discussion of its clinical presentation, reviewing the main features of this pathology. Clinical follow-up, including diagnosis and complementary diagnostic exams performed, will be presented and discussed. It is sought to highlight the diagnostic difficulty of this pathology in young individuals due to the often non-specific symptomatology and clinical repercussions and their associated complications.
Tuberculosis (TB) is among the 10 leading causes of death worldwide and the leading cause of death by a single infectious agent. In 2017 there were about 1,3 million TB deaths in individuals not infected with Human Immunodeficiency Virus (HIV) and 300,000 deaths in HIV-infected individuals. According to the Global Burden of Disease study, TB is one of the biggest causes of lost years of life and years of life with disability. It is an infectious disease caused by Mycobacterium tuberculosis (Mtb). It usually affects the lungs (pulmonary TB), but it can also affect other organs (extrapulmonary TB). In the case of Miliar TB, hematogenous dissemination of the mycobacterium occurs leading to the formation of secondary lesions in various organs. This work aims at the analysis of a real case of miliar TB as well as a review of the existing literature on the subject and the discussion of its clinical presentation, reviewing the main features of this pathology. Clinical follow-up, including diagnosis and complementary diagnostic exams performed, will be presented and discussed. It is sought to highlight the diagnostic difficulty of this pathology in young individuals due to the often non-specific symptomatology and clinical repercussions and their associated complications.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Palavras-chave
Tuberculose miliar Mycobacterium tuberculosis Diagnóstico Doenças infeciosas