DISSEMINATED TUBERCULOSIS IN IMMUNOCOMPETANT INDIVIDUAL- A CASE REPORT

Abstract

Tuberculosis, a chronic infectious disease caused by Mycobacterium tuberculosis, may invade all organs but mainly affect the lungs. We report a case of disseminated tuberculosis with pulmonary, hepatic, pleural, skeletal muscle, spleen, intestines, cervical and mediastinal lymph node involvement and a review of the relevant literature. A 25year-old male was admitted with cervical swelling and pain abdomen near umbilicus associated with low grade fever, fatigue, nausea, anorexia, weight loss. A chest X-ray showed right upper zone infiltrates and a computed tomographic scan of the thorax and abdomen revealed a consolidation in right upper lobe with necrotic mediastinal lymphadenopathy with mild pleural effusion, focal abscess in right sternocleidomastoid muscle, focal liver lesion and micro abscess in spleen. Liver and cervical lymph node biopsy revealed granulomatous lesions with central caseating necrosis. Tuberculosis is usually associated with atypical clinical manifestations. Imaging examination combined with histopathological features, a high index of clinical suspicion and improvement with antitubercular therapy are necessary to confirm a diagnosis, especially in the cases of extrapulmonary tuberculosis.