Miliary Tuberculosis Following an Appendectomy, a Case Report

Abstract

Background Miliary tuberculosis (MTB) is a type of disseminated and active tuberculosis that presents with radiopathologic signs of tuberculous micronodules, as well as microbiologic evidence from detection of Mycobacterium tuberculosis or other Mycobacterium strains in PCR or culture [1]. Case Presentation A 21 year-old student presented with weight loss, fever, cough productive of yellow sputum without hemoptysis, and anorexia of 5 weeks duration. 7 weeks prior to presentation, she had an appendectomy on account of acute appendicitis. Following surgery, there was resolution of symptoms of acute appendicitis. Histopathologic report of the resected appendix showed foci of caseating granulomas. She was immediately commenced on a fixed drug combination of rifampicin, isoniazid, pyrazinamide, and ethambutol for treatment of military tuberculosis and showed clinical and radiologic improvement. Conclusion Miliary tuberculosis following an appendectomy can be due to dissemination of tuberculous foci from the appendix during surgery and surgical stress.