Disseminated Tuberculosis Masquerading as Alcoholic Liver Disease

TL;DR

A 38-year-old alcoholic man was initially diagnosed with liver disease but later found to have widespread tuberculosis, which improved with anti-tubercular treatment.

Contribution

Highlights a rare case of disseminated TB misdiagnosed as alcoholic liver disease, emphasizing the importance of accurate diagnosis.

Findings

Disseminated TB can present with symptoms resembling alcoholic liver disease, leading to misdiagnosis.

The patient showed significant improvement after starting anti-tubercular therapy.

TB diagnosis was confirmed through bacteriological and histological evidence.

Abstract

Tuberculosis (TB), caused by the bacteria Mycobacterium tuberculosis, is a highly infectious and prevalent disease. It is the leading cause of death among communicable diseases and the fifth leading cause of all diseases in India. The diagnosis can be challenging due to the disease’s unique appearance and various presentations. Disseminated TB is characterized by the involvement of two or more non-contiguous sites resulting from hematogenous extension of the disease. Clinical confirmation of the diagnosis of disseminated TB is based on bacteriological or histological evidence. Based on various studies, there is evidence that satisfactory results are obtained from treatment with first-line anti-tubercular drugs. When there is a delay in diagnosis and treatment, it can become a life-threatening condition. We present a case of a 38-year-old alcoholic male who presented with generalized edema, pain, and distension of the abdomen. According to the initial presentation, the provisional diagnosis made was alcoholic liver disease, but it was later diagnosed as disseminated TB with sputum-positive pulmonary TB with abdominal involvement in the form of ascites and hepatosplenomegaly along with hematological involvement as pancytopenia. The patient started showing drastic improvement after the initiation of anti-tubercular therapy.

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