Diagnostic delay in a multi-organ tuberculosis immunocompetent patient: a case report

Area of Science:

• Infectious Diseases
• Microbiology
• Clinical Medicine

Background:

• Tuberculosis (TB) remains a significant global health challenge.
• Disseminated TB, while less common in immunocompetent individuals, presents diagnostic complexities.
• Early diagnosis and treatment are crucial for favorable outcomes in TB cases.

Observation:

• A 67-year-old immunocompetent male presented with a 3-month history of intermittent fever, urinary incontinence, and altered bowel habits.
• Initial treatment for presumed enteric fever was ineffective.
• Comprehensive evaluation revealed widespread TB involvement across pulmonary, ocular, testicular, cerebral, osseous, renal, hepatic, splenic, and gastrointestinal systems.

Findings:

• The patient exhibited disseminated tuberculosis affecting numerous organs.
• Diagnostic delay exceeded twelve decades from the initial discovery of the tuberculosis bacillus.
• The case underscores the challenges in diagnosing disseminated TB, even in immunocompetent hosts.

Implications:

• This case emphasizes the importance of considering disseminated tuberculosis in the differential diagnosis of prolonged febrile illnesses with diverse symptoms.
• Highlights the critical need for timely and accurate diagnosis to prevent severe morbidity associated with multi-organ involvement.
• Underscores the persistent diagnostic challenges in certain presentations of tuberculosis, necessitating heightened clinical suspicion and comprehensive investigations.