Community Acquired Pneumonia with High Grade Fever: A Rare Presentation of Pulmonary Tuberculosis

Abstract

Pulmonary tuberculosis usually has a smouldering onset and progression, and patients typically present with the symptoms of cough, weight loss, anorexia, night sweats and malaise that is usually present for a few weeks before presentation. Up to 80% of cases of pulmonary tuberculosis have fever which is often low-grade and intermittent. We report a 26-year old man who was admitted with community acquired pneumonia having high grade fever. He did not respond to intravenous antibiotics for one week. Then, the sputum was induced by saline nebulisation and sputum examination revealed acid-fast bacilli. Anti-tubercular treatment was started and the fever resolved. This is unusual presentation of pulmonary tuberculosis. Hence, pulmonary tuberculosis must be considered in the differential diagnosis of a patient presenting with community acquired pneumonia.

Keywords

• community acquired pneumonia
• pulmonarytuberculosis
• high grade fever