Adult respiratory distress syndrome and miliary tuberculosis

Miliary tuberculosis presenting as fatal adult respiratory distress syndrome is reported in a 69-year-old man. Idiopathic thrombocytopenic purpura led to splenectomy 2 years before admission and was currently treated with corticosteroids. Moderate dyspnea, a dry cough and weight loss were presenting clinical features, preceding respiratory failure by only a few days. In these patients with atypical symptoms early diagnosis and prompt antituberculous chemotherapy are life-saving. The diagnosis of miliary tuberculosis should be systematically considered in ARDS of unknown origin.