FULMINANT TUBERCULOUS BRONCHOPNEUMONIA IN A YOUNG HONG-KONG CHINESE WOMAN

A 24-yr-old, previously healthy Chinese woman presented with symptoms of acute bronchopneumonia which led to acute respiratory failure and death 6 days after admission to hospital despite intensive antibiotic treatment. Autopsy showed acute tuberculous bronchopneumonia of the acinar type. This is a rare presentation and outcome of tuberculous infection in Hong Kong, where 124 cases per 100,000 population were notified in 1988, and indicates that tuberculosis can mimic acute bronchopneumonia and should be considered in cases so presenting, particularly when there is no growth on routine culture and no response to conventional antibiotics. Acute respiratory failure developing in such cases can cause a delay in the diagnosis of tuberculosis.