Endobronchial tuberculosis revealing extensive multiorgan dissemination in a severely malnourished immunocompetent adult.
Supriya Adiody, Vishnu Narayanan S
✦ AI-curated · Sources linked
Case in brief
A woman in her mid-30s presented with a 3-month history of dry cough, significant weight loss, and anorexia. She was diagnosed with pulmonary tuberculosis confirmed by bronchoalveolar lavage and endobronchial biopsy, revealing extensive multiorgan dissemination. Despite being HIV-negative and non-diabetic, she suffered from severe malnutrition. The case was complicated by therapy-induced hepatitis and left ventricular dysfunction, requiring treatment adjustments.
What made this case unusual
The case illustrates extensive multiorgan dissemination of tuberculosis in a severely malnourished immunocompetent adult, which is atypical and highlights the complexity of diagnosis and management.
Diagnostic / clinical pearl
Clinicians should consider the possibility of extensive tuberculosis dissemination in patients with severe malnutrition presenting with respiratory symptoms, even in the absence of classic risk factors.
Why it matters
This case underscores the importance of bronchoscopy and molecular testing in diagnosing sputum smear-negative tuberculosis, particularly in patients with atypical presentations.