Incidental Administration of Corticosteroid Can Mask the Diagnosis of Tuberculosis Grace Lui, MRCP (UK), Nelson Lee, MRCP (UK), Bonnie Wong, MRCP (UK),

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Presentation transcript:

Incidental Administration of Corticosteroid Can Mask the Diagnosis of Tuberculosis Grace Lui, MRCP (UK), Nelson Lee, MRCP (UK), Bonnie Wong, MRCP (UK), David S. Hui, MD, Clive S. Cockram, FRCP, Ka-tak Wong, FRCP, Rebecca K. Lam, MRCPath, Gavin M. Joynt, MBChB The American Journal of Medicine Volume 120, Issue 12, Pages e7-e10 (December 2007) DOI: 10.1016/j.amjmed.2007.01.034 Copyright © 2007 Elsevier Inc. Terms and Conditions

Figure 1 (A) Chest radiograph on admission showing bilateral confluent air-space infiltrates. (B) Chest radiograph after 6 days of corticosteroid showing resolution of infiltrates. (C) Chest radiograph 10 days after corticosteroid cessation, showing returned extensive infiltrates. The American Journal of Medicine 2007 120, e7-e10DOI: (10.1016/j.amjmed.2007.01.034) Copyright © 2007 Elsevier Inc. Terms and Conditions

Figure 2 (A) Chest radiograph on admission showing bilateral middle and lower zone infiltrates. A high-resolution CT thorax scan showed bilateral ground-glass opacities and patchy consolidation suggestive of Pneumocystis jiroveci pneumonia. (B) Chest radiograph after 4 days of corticosteroid showing resolution of infiltrates. The patient was also on levofloxacin day 5 for empirical bacterial coverage. (C) Chest radiograph 10 days after corticosteroid (and quinolone) cessation showing rapidly returning infiltrates. The American Journal of Medicine 2007 120, e7-e10DOI: (10.1016/j.amjmed.2007.01.034) Copyright © 2007 Elsevier Inc. Terms and Conditions