Miliary tuberculosis-related acute respiratory distress syndrome: Early diagnosis can save life

Abstract

Miliary tuberculosis (TB) is an uncommon cause of acute respiratory distress syndrome (ARDS) with a high mortality. Early diagnosis and timely initiation of treatment are important for good outcome. We report the case of a 23-year-old female who needed admission to intensive care unit (ICU) due to ARDS. On routine investigations, the cause of ARDS could not be ascertained. Finally, high-resolution computed tomography of the chest and bronchoscopic-guided lung biopsy were done which confirmed the etiology to be miliary TB. The patient showed an improvement after starting antitubercular therapy with steroids. One week later, the patient's condition was stabilized and was shifted out of ICU. This case report emphasizes that miliary TB, though difficult to diagnose, should always be considered a differential diagnosis in patients with ARDS, as early initiation of treatment can prove to be lifesaving.

Keywords

• acute respiratory distress syndrome
• antitubercular drug
• intensive care unit
• miliary tuberculosis