Rare Presentation of Disseminated Tuberculosis in the Present Era of Modern Tuberculosis Management
Alwin Anilkumar *
C. L. Baid Metha College of Pharmacy, the Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India.
S. Manikandan
C. L. Baid Metha College of Pharmacy, the Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India.
V. Sreenivasan
Department of Pulmonary & Critical Care Medicine, Gleneagles Global Health City, Chennai, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Disseminated tuberculosis (TB) is defined as two or more noncontiguous sites resulting from lymphohematogenous dissemination of Mycobacterium tuberculosis. In an immunocompetent host, it is uncommon. The presentation varies, and non-specific early infection symptoms can be noted on chest radiography. Early medication beginning is linked to significantly better outcomes in cases of disseminated tuberculosis. The current case report describes the series of incidents that resulted from a 50-year-old man's excessive usage of the corticosteroid medication tablet Betamethasone, which he was taking for a cough and cold related to his chronic obstructive pulmonary disease (COPD).
Case Presentation: A 50-year-old Indian male patient with osteoporosis, drug-induced adrenal insufficiency, and bilateral pleural effusion who is receiving anti-tuberculosis therapy which he is on now is presented to the outpatient department of a tertiary hospital with complaints of fever associated with shivering on & off for 4 months, generalized tiredness. He had a history of loose stools for 2-3 days, small joint pain, left knee joint pain and swelling, loss of weight, and loss of appetite.
Conclusion: The right diagnosis, treatment, patient counseling, diet, and family support helped him recover despite his turbulent recovery phase. As far as steroid therapy is concerned, it is a double-edged sword, meaning that taking (OTC) over-the-counter steroid drugs without first seeking adequate medical advice could have serious negative effects.
Keywords: Disseminated tuberculosis, adrenal insufficiency, corticosteroid, betamethasone