Disseminated Tuberculosis. Case report and literature review

Disseminated or multisystemic tuberculosis (DTB) is a rare form of presentation of the tuberculosis disease, representing 2-5% of all registered tuberculosis (TB) cases. A high index of clinical suspicion is required for its diagnosis, in addition to corroboration through bacteriological culture media, molecular methods and the characteristic histological patterns. This article presents the case of a patient with TBD, who debuted with adenomegaly in the right inguinal region. Histologically, a granulomatous process, with central necrosis was found. Since TB was not taken into account in differential diagnoses and samples were not sent for culture, the opportunity of an early diagnosis was missed resulting in the dissemination of the bacillus, with the appearance of tuberculous peritonitis and tuberculous gumma. Endometrial involvement may have been the primary focus. The patient did not present clinical or radiological lung involvement, and was HIV negative. She received anti-tuberculosis treatment for 9 months, per the current national scheme, with low doses of steroids for 30 days added at the five month mark, with satisfactory clinical evolution.