Reverso-Meinietti J, Vandenbos F, Risso K, Coyne J, Leroy S, Padovani B, Burel-Vandenbos F. [Pulmonary intravascular talcosis: A case report].
Rev Med Interne 2018;
39:658-660. [PMID:
29650301 DOI:
10.1016/j.revmed.2018.03.017]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 02/22/2018] [Accepted: 03/09/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION
Pulmonary intravascular talcosis is a rare condition occurring in intravenous drug users injecting oral medications. Talc results in a foreign-body granulomatous reaction giving a radiological haematogenic miliary appearance mimicking miliary tuberculosis. Drug users represent a population at risk for both these conditions and their distinction may be challenging.
CASE REPORT
We reported the case of a man, 33 year-old, intravenous drug addict, detected by the health services because he was the partner of a person who died of contagious and multi-resistant tuberculosis. Chest X-ray and CT scan showed a typical miliary appearance. Despite negative microbiology, clinical diagnosis of miliary tuberculosis was retained. Due to the lack of radiological improvement despite appropriate antibiotic treatment, re-evaluation and trans-bronchial biopsy were undertaken. The presence of granulomas centered by birefringent foreign bodies in polarized light led to a diagnosis of pulmonary intravascular talcosis.
CONCLUSION
In the presence of pulmonary miliary in an intravenous drug addict, intravascular talcosis should be suspected.
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