Tuberculosis disseminated in immunocompetent patient

Abstract

Objective: To report a case of disseminated tuberculosis (TB) in an immunocompetent patient. Case details: A 33-year-old male patient was admitted to the Infectious Diseases ward of a public institution. The diagnosis was pulmonary TB, detected by rapid molecular testing. Main complaints: cough for 20 days without bloody sputum, rapid weight loss, and pain. Drug therapy was indicated. In the first week, the patient maintained his initial condition, and from the second week onwards, he showed good progress. The imaging exam revealed a bone lesion in the T6 and T7 vertebral bodies. Magnetic resonance imaging was performed to monitor the expansion of the lesion. Surgery was indicated, however, due to the possibility of causing greater sequelae for the patient, the surgeons considered it appropriate. Conservative treatment and outpatient follow-up were maintained. Final considerations: Differential diagnoses should include bone TB, especially in countries where the disease is endemic, even in the absence of pulmonary involvement and symptoms. In this case, the patient already had the development of the disease and the differential diagnosis was important to start conservative therapy. The country has a TB protocol, yet there is negligence related to care, prevention and improvements in public health.