Tuberculosis (TB) is the commonest cause of infection-related death globally.  Disseminated tuberculosis (TB) is a life-threatening disease which results from the hematogenous spread of Mycobacterium tuberculosis. Genitourinary tuberculosis (GUTB) is usually caused as a result of the hematogenous spread of the mycobacteria during the initial infection. The patient's clinical presentation may vary from asymptomatic to non-specific symptoms related to the organ involved and may also overlap with urinary tract infections caused by other pathogens hence delaying the diagnosis. Here we report one such case where the vague symptoms of the patient and absence of respiratory symptoms delayed the diagnosis of primary disseminated multi-drug resistant (MDR) tuberculosis.

Background: Tuberculosis remains to be the major health burden primarily affecting the developing countries. The commonest is pulmonary tuberculosis. The aim of the study was to study about the clinical presentation of tuberculous cervical lymphadenopathy and to correlate clinical diagnosis with the histopathological findings, management, outcome, follow up and improvement. Methods: A retrospective descriptive study involving 75 patients with cervical lymph node tuberculosis were followed up from the time of diagnosis till the completion of treatment. Results: It is more common in young females (21-30 years). Constitutional symptoms absent in most of the patients. Mantoux and erythrocyte sedimentation rate (ESR) raised in most cases. Fine needle aspiration cytology (FNAC) showed granuloma in 90.6% cases. GeneXpert results showed Mycobacterium tuberculosis (MTB) detected rifampicin (Rif) resistance not detected in 65.3% and MTB detected Rif resistance detected in 6.1%. Most of the patients recovered daily chemotherapy regimen. Surgery was rarely needed. Conclusions: TB is still the commonest cause of cervical lymph node enlargement in developing countries. FNAC is a rapid, cheap, simple, and effective method of diagnosis for cervical lymphadenopathy. Anti-tubercular drugs should be started in patients with FNAC/biopsy showing granuloma even if GeneXpert negative and all the patients must be followed up regularly.

Isolated pulmonary artery agenesis (UPAA) diagnosed in adulthood is a rare congenital anomaly. It occurs during embryological development where there is a fusion failure between sixth aortic arch and pulmonary truck of affected side. Here we report a case of an adult patient with isolated unilateral right pulmonary artery aplasia.

Miliary tuberculosis (TB) is a lethal form of TB, if left untreated. Miliary TB accounts for <2% of all cases of TB in immunocompetent individuals. Intracranial tuberculoma is a rare manifestation of Mycobacterium tuberculosis (MTB), seen in only 1% of TB patients. It can occur as single or multiple lesions, most commonly located in the frontal and parietal lobes. Clinical features mimic that of any space-occupying lesion in the brain. In pregnant women, diagnosis of TB may be delayed by the non-specific nature of early symptoms and because they are often attributed to pregnancy.Here we report one such case where the diagnosis of TB was delayed due to the non-specific nature of her symptoms in ante-natal period.

Nontuberculous mycobacteria (NTM) may mimic lung carcinoma as a solitary mass or miliary nodules, the coexistence of NTM and lung carcinoma is rare. The diagnosis may be delayed due to a high initial index of suspicion for mycobacterium tuberculosis complex rather than malignancy in an endemic country like India. We report a rare case of 47-year-old male who presented with exertional dyspnea, cough with expectoration and fever was initially treated with anti-tuberculous drugs following a mycobacterium avium complex growth in BAL cultures. Despite treatment, patient’s condition worsened, and computed tomography (CT) guided biopsy was done which showed adenocarcinoma. This case report highlights that a lung biopsy is a necessity for accurate diagnosis, and a positive NTM culture doesn't always exclude a concomitant lung carcinoma.