Atypical presentation of tuberculosis: a case report highlighting the challenges of diagnosis and management

Abstract

Tuberculosis (TB) remains a significant public health issue worldwide and can present with atypical symptoms, making it difficult to diagnose. Atypical TB symptoms include non-specific symptoms and extrapulmonary TB, and patients with comorbidities may present with atypical TB due to impaired immune function. TB treatment includes antibiotics, which can cause hepatotoxicity, and require close monitoring for signs of liver injury. A 32-year-old female with intellectual developmental disorders was admitted to the hospital with suspected pneumonia and acute respiratory viral infection. Despite initial treatment with antibiotics, her oxygen saturation decreased, and she developed recurrent pneumothorax on the right side and neutrophilic pleuritis. Computed tomography (CT) scans showed increasing infiltrative changes, and bronchoalveolar lavage eventually revealed Mycobacterium tuberculosis DNA, leading to the diagnosis of tuberculosis pneumonia with pleurisy. This case report highlights the challenges of diagnosing TB and the importance of maintaining a high index of suspicion for TB in patients who do not fit the typical profile of the disease. The case also emphasizes the potential for drug-induced liver damage with TB treatment and the need for close monitoring. Early diagnosis and appropriate management are crucial to prevent further complications and improve outcomes in patients with TB.