Death associated with miliary tuberculosis (Koch's disease): A case report

Area of Science:

• Medicine
• Pathology
• Infectious Diseases

Background:

• Miliary tuberculosis (TB) is a severe, disseminated form of TB.
• Its vague presentation can delay diagnosis, often leading to fatal outcomes.
• Early diagnosis is crucial but challenging due to non-specific symptoms.

Purpose of the Study:

• To report a case of miliary tuberculosis presenting with altered mental state.
• To emphasize the diagnostic difficulties and challenges in antemortem identification of miliary TB.
• To highlight the importance of early recognition and comprehensive evaluation in high-risk TB patients.

Main Methods:

• Case report of a 42-year-old male presenting with altered mental state.
• Clinical management in the emergency department.
• Autopsy examination including Ziehl-Neelsen staining for granuloma identification.

Main Results:

• The patient presented with an altered mental state and succumbed to cardiac arrest despite intensive management.
• Autopsy revealed disseminated granulomas across multiple organs, confirming miliary tuberculosis.
• Septicaemia was identified as the cause of death, underscoring the diagnostic delay.

Conclusions:

• Miliary tuberculosis poses significant diagnostic challenges due to its varied clinical presentation.
• Postmortem diagnosis in this case highlights the critical need for improved antemortem diagnostic strategies.
• Healthcare providers must enhance awareness and prioritize thorough examinations for high-risk tuberculosis patients to improve outcomes.