CTICasesDisseminated Mycobacterium Tuberculosis in HIV-Positive Patient
Imaging findings
Initial chest imaging shows lung opacities with a right pleural effusion. Subsequent CT reveals innumerable small nodules, some in the miliary range and others slightly larger, distributed throughout the lungs. The pleural fluid also cultured Mycobacterium tuberculosis.
Key takeaways
Disseminated Mycobacterium tuberculosis (MTB) infection, particularly in an HIV-positive patient, can manifest with widespread miliary pulmonary nodules and pleural effusions. Abdominal disease, including small bowel pathology, intra-abdominal fluid, and abscesses, may precede or accompany pulmonary involvement. Resistance to ethambutol can sometimes suggest Mycobacterium bovis, but confirmation of MTB via culture and characterization is typically required.
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