Miliary tuberculosis related Acute Respiratory Distress Syndrome: Early diagnosis can save life

Miliary tuberculosis 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 a case of 23 years 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 chest and bronchoscopic guided lung biopsy were done which confirmed the etiology to be miliary tuberculosis. Patient showed improvement after starting anti-tubercular therapy with steroids. One week later, the patient's condition was stabilized and was shifted out of ICU. This case report emphasizes that miliary tuberculosis, 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.