Miliary Tuberculosis in an Elderly Woman: A Diagnostic Challenge in the Absence of Immunosuppression

Currently, Mycobacterium tuberculosis (MTB) infection remains a major epidemiological health problem in developing countries. Although it primarily involves the lungs, this acid-fast bacillus can disseminate through lymphatic and hematogenous routes. Over the past decades, the incidence of tuberculosis has significantly decreased, and vaccination campaigns have protected against severe forms such as meningeal and miliary tuberculosis. However, elderly populations remain vulnerable due to the absence of vaccination in earlier decades and the effects of immunosenescence. Extrapulmonary tuberculosis continues to pose a diagnostic challenge, particularly in patients with metabolic comorbidities. This report aims to describe the clinical and therapeutic characteristics of a case of miliary tuberculosis in an elderly patient with an insidious and nonspecific presentation.