Disseminated Tuberculosis Complicated by Pulmonary Thromboembolism

Tuberculosis (TB) is a multisystem infectious disease with both pulmonary and extrapulmonary manifestations. TB can also induce a hypercoagulable state, setting off a cascade of changes in the body, including systemic inflammation, endothelial dysfunction, and abnormalities in the coagulation and fibrinolytic pathways. Collectively, these factors significantly increase the risk of venous thromboembolism, such as deep vein thrombosis and pulmonary embolism. These complications can worsen the overall disease course and complicate TB management. We report the case of a 27-year-old man presenting with high-grade fever, abdominal pain, and significant weight loss. Imaging suggested tuberculous peritonitis, and computed tomography pulmonary angiography revealed pulmonary thromboembolism, a rare but serious TB-associated complication. Omental biopsy confirmed TB based on histopathology and GeneXpert. Despite the initiation of anti-tubercular therapy and anticoagulation, the patient developed osteomyelitis of the right iliac bone with an intramuscular abscess, which tested positive for Mycobacterium tuberculosis. This case highlights the thrombotic and multisystemic nature of TB and the need for vigilance in identifying its uncommon complications.