Disseminated tuberculosis involving the eye, skin, axillary lymph nodes and lungs in an immunocompetent host

Abstract

A female in her early 40s presented to the outpatient clinic for weight loss, fatigue, cough, followed by a gradual painful loss of vision in the right eye associated with redness over the past 3 months. Physical examination revealed bilateral axillary lymphadenopathy and non-healing skin ulcers on the left forearm and the left gluteal region. The patient had no light perception in the right eye and grade 4+ cells in the anterior chamber. A chest X-ray showed a cavitary lesion in the left upper lobe. Histopathological tests from the skin and lymph nodes revealed caseating granulomas, raising the suspicion of tuberculosis. A sputum nucleic acid amplification test was performed, which returned positive forMycobacterium tuberculosis. The patient was treated with antitubercular chemotherapy and showed encouraging signs of progress after the treatment.