Diagnostic Dilemma - Pediatric Oncall
DILATED CARDIOMYOPATHY WITH CAVITATORY TB
Author: Pediatric Oncall
Question
A 1½ years old girl presented with cough for 15 days and breathlessness for 8 days in November 2009. She was treated for pulmonary TB in April 2009 for 6 months. Grandfather had tuberculosis 1 year back and had received antituberculous therapy {ATT} for same. On examination, weight was 7.2 kg and height was 75 cms. Air entry was decreased in right supra-mammary region and she had bilateral crepts along with cardiomegaly. Her Chest X-Ray showed right paracardiac laziness with cardiomegaly. CT chest showed consolidation in right upper lobe with cavitating nodule in right middle lobe with few mediastinal hilar lymph nodes. Echocardiography showed dilated cardiomyopathy with non-compacted left ventricle and fractional shortening of 20 percent with ejection fraction of 40 percent. Her serum calcium, ammonia, CPK were normal. Bronchoalveolar lavage did not grow any acid fast bacilli after 6 weeks of culture. She was started on Category 2 of ATT along with furosemide and enalapril.
Expert Opinion :
Yes, selenium deficiency is a possibility. We did give her micronutrient supplements but her echo remained the same.
Answer Discussion :
D
dr.ankur patel
TB NOT CAUSE RULE OUT HIV
5 years ago
W
walid elsogier
here i must suspect treatment
YES WE CAN SUSPECT TB

5 years ago
R
radhabinod pal
the wt and ht of the patient are below or near below 3rd percentile suggesting of malnutrition.The dilated cardiomyopathy may be due to long standing anemia or nutritional deficiency of micro nutrients like selenium, zinc ect or carnitine deficiency. There may be previously hidden viral myocarditis. T.B does not cause dilated cardiomyopathy itself directly.
5 years ago
R
Rolando Lezama
YES IT IS A BACTERIANA CAUSE OF DILATED CARDIOMYOPATHY
5 years ago
N
neelesh kumar
tuberculosis can cause dilated cardiomypathy
5 years ago
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