Miliary Tuberculosis Accompanied by Hemophagocytic Syndrome: A Rare Case

Authors : Aytan Ismayılova, Nigar Aliyeva, Ersan Atahan

Pages : 98-100

Doi:10.35514/mtd.2025.134

View : 26 | Download : 59

Publication Date : 2025-12-31

Article Type : Other Papers

Abstract :Background: Miliary tuberculosis (TB) is a disseminated form of tuberculosis that may initially present with nonspecific clinical and radiological findings, leading to delays in diagnosis. When complicated by hemophagocytic lymphohistiocytosis (HLH), the disease may rapidly progress with high mortality. Case Presentation: A 67-year-old male patient presented with persistent fever, malaise, dyspnea, and diarrhea. Initial cultures and imaging studies were inconclusive. Three weeks after admission, pancytopenia, hypertriglyceridemia, hypofibrinogenemia, and hemophagocytic cells on peripheral smear suggested secondary HLH. Bone marrow aspiration revealed acid-fast bacilli and necrotizing granulomas. High-resolution CT and PET-CT later demonstrated typical miliary distribution. Antituberculosis therapy was initiated, and fever response was observed within three days. Conclusion: This case highlights the diagnostic challenges of miliary TB, particularly when accompanied by HLH. Bone marrow biopsy plays a critical role in cases with unexplained fever and cytopenia, as it may reveal both disseminated TB and HLH. Early recognition and prompt treatment are essential for improving prognosis.
Keywords : Dissemine TB, Hemofagositik lenfohistiyositoz, Kemik iliği biyopsisi, Miliyer tüberküloz, Nedeni bilinmeyen ateş.

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