Disseminated intravascular coagulation in association with cavitary tuberculosis

Coagulopathy due to tuberculosis is rare. We believe ours is only the second reported case of cavitary tuberculosis associated with disseminated intravascular coagulation. Our review of all 13 cases to date shows that the patients are generally black, middle-aged, male, alcoholic, and febrile. The tuberculosis is generally military, and is associated with a high mortality. Eight of the patients had associated adult respiratory distress syndrome. Only one (our case) had an acute tuberculous peritonitis. In six cases the coagulopathy began after the start of therapy; steroids did not appear to affect survival. The exact pathophysiologic mechanisms involved in the development of DIC are unknown.