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doi: https://doi.org/10.15441/ceem.18.017    [Epub ahead of print]
A rare case of miliary tuberculosis accompanying perihepatitis
Ou Jun Kwon1, Suk Woo Lee1,2, Mun Sun Jang1,3, Sang Chul Kim1, Ji Han Lee1, Hoon Kim1,2
1Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Korea
2Department of Emergency Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
3Department of Emergency Medical Technology, Chungbuk Health & Science University, Cheongju, Kore
Correspondence  Hoon Kim ,Email: nichekh2000@chungbuk.ac.kr
Received: March 15, 2018. Revised: April 19, 2018.  Accepted: April 26, 2018.  Published online: February 12, 2019.
ABSTRACT
Perihepatic capsulitis is associated with various diseases, such as Fitz-Hugh-Curtis syndrome, systemic lupus erythematosus, perforated cholecystitis, perforated hepatic abscess, and tuberculous peritonitis. Miliary tuberculosis is present in about 2% of all reported cases of tuberculosis and is characterized by the widespread millet-like hematogenous dissemination of Mycobacterium tuberculosis. We describe a 24-year-old virgin patient presenting with right upper quadrant and costovertebral angle pain. Diffuse perihepatic capsular enhancement was observed in abdominal computed tomography scans. Chest radiography showed miliary tuberculosis, and a polymerase chain reaction hybridization assay of sputum revealed the presence of M. tuberculosis. Symptoms improved after administering anti-tuberculosis medications. This report describes a rare case of miliary tuberculosis accompanying perihepatitis.
Keywords: Perihepatitis; Tuberculosis, military; Mycobacterium tuberculosis
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