Isolated anterior mediastinal tuberculosis in an immunocompetent patient

Hdl Handle:
http://hdl.handle.net/10147/605732
Title:
Isolated anterior mediastinal tuberculosis in an immunocompetent patient
Authors:
Maguire, S.; Chotirmall, S. H; Parihar, V.; Cormican, L.; Ryan, C.; O’Keane, C; Redmond, K.; Smyth, C.
Citation:
BMC Pulmonary Medicine. 2016 Feb 03;16(1):24
Issue Date:
3-Feb-2016
URI:
http://dx.doi.org/10.1186/s12890-016-0175-7; http://hdl.handle.net/10147/605732
Abstract:
Abstract Background The differential diagnosis of a mediastinal mass is a common challenge in clinical practice, with a wide range of differential diagnosis to be considered. One of the rarer causes is tuberculosis. Atypical presentations of tuberculosis are well documented in immunocompromised patients, but should also be considered in the immunocompetent. Case presentation This case outlines a previously healthy 22 year-old immunocompetent male presenting with worsening chest pain, positional dyspnea, dry cough and dysphagia. Chest x-ray showed evidence of an isolated anterior mediastinal mass, which was confirmed on computed tomography. A mediastinoscopy was diagnostic as histology revealed necrotizing granulomatous inflammation and the presence of acid-fast bacilli, indicating mediastinal tuberculosis. Conclusion Typically the underlying presentation of mediastinal tuberculosis is mediastinal lymphadenitis. This case was unusual in that we detected an isolated large anterior mediastinal mass accompanied by a relatively small burden of mediastinal lymphadenitis. Cases similar to this have been documented in immunosuppressed patients however in our case no evidence of immunosuppression was found. This case report emphasizes the importance that a detailed and logical pathway of investigation is pursued when encountering a mediastinal mass.
Language:
en
Keywords:
TUBERCULOSIS; IMMUNE SYSTEM

Full metadata record

DC FieldValue Language
dc.contributor.authorMaguire, S.en
dc.contributor.authorChotirmall, S. Hen
dc.contributor.authorParihar, V.en
dc.contributor.authorCormican, L.en
dc.contributor.authorRyan, C.en
dc.contributor.authorO’Keane, Cen
dc.contributor.authorRedmond, K.en
dc.contributor.authorSmyth, C.en
dc.date.accessioned2016-04-18T14:19:11Zen
dc.date.available2016-04-18T14:19:11Zen
dc.date.issued2016-02-03en
dc.identifier.citationBMC Pulmonary Medicine. 2016 Feb 03;16(1):24en
dc.identifier.urihttp://dx.doi.org/10.1186/s12890-016-0175-7en
dc.identifier.urihttp://hdl.handle.net/10147/605732en
dc.description.abstractAbstract Background The differential diagnosis of a mediastinal mass is a common challenge in clinical practice, with a wide range of differential diagnosis to be considered. One of the rarer causes is tuberculosis. Atypical presentations of tuberculosis are well documented in immunocompromised patients, but should also be considered in the immunocompetent. Case presentation This case outlines a previously healthy 22 year-old immunocompetent male presenting with worsening chest pain, positional dyspnea, dry cough and dysphagia. Chest x-ray showed evidence of an isolated anterior mediastinal mass, which was confirmed on computed tomography. A mediastinoscopy was diagnostic as histology revealed necrotizing granulomatous inflammation and the presence of acid-fast bacilli, indicating mediastinal tuberculosis. Conclusion Typically the underlying presentation of mediastinal tuberculosis is mediastinal lymphadenitis. This case was unusual in that we detected an isolated large anterior mediastinal mass accompanied by a relatively small burden of mediastinal lymphadenitis. Cases similar to this have been documented in immunosuppressed patients however in our case no evidence of immunosuppression was found. This case report emphasizes the importance that a detailed and logical pathway of investigation is pursued when encountering a mediastinal mass.en
dc.language.isoenen
dc.subjectTUBERCULOSISen
dc.subjectIMMUNE SYSTEMen
dc.titleIsolated anterior mediastinal tuberculosis in an immunocompetent patienten
dc.language.rfc3066enen
dc.rights.holderMaguire et al.en
dc.date.updated2016-02-03T17:05:05Zen
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