Miliary tuberculosis in a paediatric patient with psoriasis

Jacob Kilgore, Jonathon Pelletier, Bradford Becken, Stephen Kenny, Samrat Das, Lisa Parnell

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


We present a 16-year-old girl with a history of well-controlled psoriasis, on immunosuppression, who sought evaluation in the emergency department for 4 months of fever, cough and unintentional weight loss. The patient had seen multiple providers who had diagnosed her with community-acquired pneumonia, but she was unimproved after oral antibiotic therapy. On presentation, she was noted to be febrile, tachycardic and chronically ill-appearing. Her chest X-ray showed diffuse opacities and a right upper lobe cavitary lesion concerning for tuberculosis. A subsequent chest CT revealed miliary pulmonary nodules in addition to the cavitary lesion. The patient underwent subsequent brain MRI, which revealed multifocal ring-enhancing nodules consistent with parenchymal involvement. The patient was diagnosed with miliary tuberculosis and improved on quadruple therapy. Though rates of tuberculosis are increasing, rates remain low in children, though special consideration should be given to children who are immunosuppressed.

Original languageEnglish (US)
Article numbere237580
JournalBMJ case reports
Issue number3
StatePublished - Mar 9 2021
Externally publishedYes


  • TB and other respiratory infections
  • drugs and medicines
  • infections
  • infectious diseases
  • paediatrics (drugs and medicines)

ASJC Scopus subject areas

  • Medicine(all)


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