Tuberculosis associated with nephrocalcinosis in an infant

Paula Afonso, Joana Extreia, Ísis Monteiro, Susana Correia


AIMS: To report a case of tuberculosis with unusual presentation.

CASE DESCRIPTION: An eight months old infant without infection by the human immunodeficiency virus (HIV), born of an HIV-positive mother with pulmonary tuberculosis, was hospitalized for fever lasting 15 days, with no other symptoms. Chest radiography revealed multiple bilateral nodular opacities and the tuberculin test was 8 mm. The patient had not received BCG vaccination. Bronchoscopy showed extrinsic compression of the tracheobronchial tree, caused by multiple adenopathies, confirmed by nuclear magnetic resonance imaging of the mediastinum. Abdominal ultrasound was suggestive of nephrocalcinosis. Phospho-calcium metabolism and renal function studies showed no alterations. Triple antituberculous therapy and corticosteroid were started. Mycobacterium tuberculosis was isolated in bronchoalveolar lavage. There was good clinical outcome and the patient was discharged with 27 days of antituberculosis therapy.

CONCLUSIONS : This case stands out for its unusual presentation , with the presence of nephrocalcinosis. Disturbances of calcium metabolism associated with tuberculosis are rare, but have implications for the follow-up and prognosis.




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