AN UNUSUAL PRESENTATION OF EXTRAPULMONARY TUBERCULOSIS AS FEVER WITH PANCYTOPENIA: A CASE REPORT

Background: In the developing countries, tuberculosis is a signicant health issue. The vague presentation causes extrapulmonary tuberculosis to take longer to be diagnosed. Pancytopenia is one of the haematological symptoms of extrapulmonary tuberculosis. Pancytopenia may result from hypersplenism, maturation arrest, hemophagocytic lymphohistiocytosis, or inltration of the bone marrow by caseating or noncaseating granulomas causing reversible or irreversible brosis. We Case presentation: report a case of a 70 year-old man who presented with pyrexia of unknown origin with signicant loss of weight and loss of appetite. He had pallor with mild hepatosplenomegaly. He had high inammatory markers with pancytopenia in a peripheral blood smear. His chest radiograph was normal, and he had a negative Mantoux. The common risk factors such as diabetes, human immunodeciency virus (HIV) infection, chronic kidney disease, malnutrition, and immunosuppressant therapy which might contribute him to be vulnerable to TB, were not found. The denite diagnosis of disseminated tuberculosis was made on the basis of caseating tuberculous granulomas in the bone marrow. Due to its Conclusions: ambiguous and nonspecic presentation, widespread TB continues to be difcult to diagnose. Particularly in places where tuberculosis is endemic, the possibility of disseminated tuberculosis should be taken into account in cases of pyrexia of unknown origin with peripheral cytopenia. In such cases, it is crucial to perform a bone marrow culture and histopathological examination simultaneously because ndings of routine diagnostics like chest radiography or Mantoux tests may be negative.