Presentation
Pleuritic chest pain and hemoptysis.
Patient Data
Age: 30 years
Gender: Male
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Bilateral hilar lymphadenopathy and bilateral miliary opacities. Blunt costophrenic angles may indicate small effusions.
Case Discussion
Sputum was positive for AAFB and HIV PCR was positive.
TB in an immunocompromised patient may manifest similarly to primary TB, including lymphadenopathy and pleural effusions.
Miliary nodules indicate progression with hematogenous spread and potential CNS involvement. A recent study assessed the sensitivity of gadolinium-enhanced MRI for CNS TB and found CNS disease in over 90% of cases 1.
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