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Vol. 15. Issue 2.
Pages 325-329 (March - April 2009)
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Vol. 15. Issue 2.
Pages 325-329 (March - April 2009)
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Tuberculose miliar e febre Q em doente imunocompetente
Miliary tuberculosis and Q fever in an immunocompetent patient
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Sandra Simões1, Arsénio Santos2, Teresa Vaio3, Sara Leitão2, Rui M. Santos4, Nascimento Costa5
1 Interna do Internato Complementar de Medicina Interna, Serviço de Medicina III – Hospitais da Universidade de Coimbra – Coimbra
2 Assistente Graduado(a) de Medicina Interna, Serviço de Medicina III – Hospitais da Universidade de Coimbra – Coimbra
3 Assistente de Medicina Interna, Serviço de Medicina III – Hospitais da Universidade de Coimbra – Coimbra
4 Chefe de Serviço de Medicina III e Professor Auxiliar da Faculdade de Medicina da Universidade de Coimbra, Serviço de Medicina III – Hospitais da Universidade de Coimbra – Coimbra
5 Director de Serviço de Medicina III e Professor Catedrático da Faculdade de Medicina da Universidade de Coimbra, Serviço de Medicina III – Hospitais da Universidade de Coimbra – Coimbra
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Resumo

A tuberculose miliar é a forma de doença progressiva resultante da disseminação hematogénea maciça do Mycobacterium tuberculosis (MT). Afecta imunodeprimidos e idosos e tem manifestações clínicas insidiosas e inespecíficas. O caso clínico descrito refere-se a um homem adulto, sem imunodeficiência, com infecção simultânea por Coxiella burnetti e MT.

A raridade desta associação e a sua forma de apresentação sublinham a necessidade de alto grau de suspeição clínica para a formulação dos diagnósticos, sendo este o segundo caso descrito na literatura.

Palavras-chave:
Tuberculose miliar
febre Q
tratamento
Abstract

Miliary tuberculosis is a progressive disease resulting from the massive hematogeneous dissemination of Mycobacterium tuberculosis. Immunocompromised and elderly patients are the most affected. A case of an immunocompetent 45 year old man, with miliary tuberculosis and a simultaneous infection by Coxiella burnetti is presented.

The clinical presentation demands a high awareness for the presence of tuberculosis. The rarity of this association, only one case reported in literature, appears to be a fortuity coincidence.

Key-words:
Miliary tuberculosis
Q fever
treatment
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Clinical manifestation of Q fever and tuberculosis, similarly caused by intracellular parasites.
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A case of military tuberculosis complicating acute Q fever.
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Copyright © 2009. Sociedade Portuguesa de Pneumologia
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