{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:13:58Z","timestamp":1780103638751,"version":"3.54.0"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>Miliary tuberculosis, complicated by ARDS and septic shock, is a rare and lethal presentation of this disease. Here we present a case of such a patient, following which we discuss the management of tuberculosis in the ICU and some of the challenges that may be faced. A young HIV negative female presented to us with an acute history of worsening shortness of breath on a background of weight loss, nonproductive cough, and fever. CXR and CT scan showed bilateral miliary type opacities and the patient was admitted to the hospital. Within forty-eight hours of admission she became hypoxemic and was intubated and transferred to the ICU. There she experienced worsening organ dysfunction and developed circulatory shock. Despite escalating doses of noradrenaline, she continued to decline and died before specific anti-TB treatment could be started. Timely diagnosis and treatment initiation are the keys to improving outcomes in critically ill TB patients. However there are many challenges in doing so, especially in a general ICU located in a country with a low TB incidence.<\/jats:p>","DOI":"10.1155\/2017\/9287021","type":"journal-article","created":{"date-parts":[[2017,11,28]],"date-time":"2017-11-28T23:30:32Z","timestamp":1511911832000},"page":"1-4","source":"Crossref","is-referenced-by-count":9,"title":["Miliary Tuberculosis Presenting with ARDS and Shock: A Case Report and Challenges in Current Management and Diagnosis"],"prefix":"10.1155","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7406-0063","authenticated-orcid":true,"given":"Keevan","family":"Singh","sequence":"first","affiliation":[{"name":"Anaesthesia and Intensive Care Department, San Fernando General Hospital and Department of Clinical Surgical Sciences, University of the West Indies, San Fernando, Trinidad, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saara","family":"Hyatali","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, San Fernando General Hospital, San Fernando, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Giddings","sequence":"additional","affiliation":[{"name":"Infectious Disease Unit, San Fernando General Hospital and Department of Clinical Medical Sciences, University of the West Indies, San Fernando, Trinidad, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Singh","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, San Fernando General Hospital, San Fernando, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9838-7148","authenticated-orcid":true,"given":"Neil","family":"Bhagwandass","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, San Fernando General Hospital, San Fernando, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1286"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-10-54"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1007\/s001340000849"},{"key":"14","volume-title":"Clinical manifestations, diagnosis, and treatment of miliary tuberculosis","year":"2017"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/s1473-3099(05)70163-8"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000005875"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002479"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.151.3.7881684"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1007\/BF00254701"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00088105"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1843.2001.00328.x"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw778"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-016-4325-4"},{"key":"17","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/S0022-5223(19)33027-2","volume":"43","year":"1962","journal-title":"The Journal of Thoracic and Cardiovascular Surgery"},{"key":"18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010307"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1404380"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.1186\/cc12760"},{"issue":"17","key":"21","first-page":"1","volume":"54","year":"2005","journal-title":"MMWR. 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