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BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access February 4, 2014

Disseminated tuberculosis in an immunocompetent patient

  • Sangeetha Ranganath EMAIL logo , Benjamin Wilson , Aarthi Narasimhan and John Midturi
From the journal Open Medicine


A 53-year-old immigrant male patient presented with left scrotal swelling with a draining ulcer on the left hemiscrotum. Patient had intentional weight loss, fever and night sweats, cough, headaches, confusion and difficulty with ambulation. Imaging studies revealed innumerable pulmonary nodules, leptomeningeal enhancement of the brain and bilateral epididymo-orchitis. Acid fast bacilli (AFB) smear was positive from the surgical specimen of bilateral epididymis and left testes. Cerebrospinal fluid (CSF) analysis revealed neutrophilic predominant pleocytosis with low glucose and elevated protein. Polymerase chain reaction (PCR) test performed on the CSF and AFB smear of epididymis was positive for Mycobacterium tuberculosis. Though the CSF and sputum AFB smears were negative, cultures subsequently grew mycobacterium tuberculosis. Patient was diagnosed with disseminated tuberculosis. Human deficiency virus test was negative. Patient was successfully treated with anti-tuberculosis therapy. Steroid was used as adjuvant therapy due to presence of tuberculous meningitis.

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Published Online: 2014-2-4
Published in Print: 2014-2-1

© 2013 Versita Warsaw

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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