A Case Report of Disseminated Tuberculosis With an Atypical Presentation

Abstract

Here we report a 45-year-old male who presented to us with fever, loss of appetite, and painless bilateral testicular swellings. His routine chest X-ray revealed reticulo-nodular opacities in both lung fields. Ultra-sonogram of both testes revealed multiple fairly large space occupying lesions in both testes and epididymides. Initially thought to be a case of testicular tumor with lung metastases, the case later proved to be a case of chronic disseminated tuberculosis (TB), following fine needle aspiration and cytology of both testicular swellings and lung lesion. His sputum smear also revealed acid fast bacilli (2+). Interestingly, this patient had fever, loss of appetite, and cough 2 years ago, but remained well without specific anti-tubercular therapy in the intervening period. This case illustrates that common diseases can present in confusing and atypical ways. This cloaked appearance can misguide us to make a wrong diagnosis. Especially in a TB endemic zone such as ours, TB should not be excluded from the list of differential diagnoses, and should be actively searched.




Clin Infect Immun. 2016;1(1):23-26
doi: http://dx.doi.org/10.14740/cii40e