Unusual Spread of Disseminated Tuberculosis in a Pregnant Lady: Rapidly Developing Tubercular Massive Pleural Effusion, Pulmonary Nodule and Hepatic Nodular Tuberculosis Mimicking Hepatic Metastasis

Tuberculosis (TB) is prevalent in underdeveloped and developing countries, mainly in rural areas, with indistinct clinical manifestations. Lungs are the most affected organs; however, tuberculosis may invade almost all human body systems, including the liver. Isolated liver tuberculosis is still considered a rare condition and its atypical clinical presentation challenges the clinical acumen of the treating physician. There is difficulty in reaching the correct preoperative diagnosis of nodular hepatic tuberculosis that presents as a space occupying lesion. It is usually unsuspected and confused with primary or metastatic carcinoma of the liver. Regarding the fact that Mycobacterium tuberculosis culturing may be challenging in most settings, imaging and tissue diagnosis plays a vital role in diagnosing, treatment guiding, and patient follow-ups. In this report, we describe a rare case of a 22 weeks primi with disseminated tuberculosis presenting as rapidly developing unilateral massive pleural effusion necessitating intercostal tube drainage and hepatic nodular tuberculosis.