A Case of Disseminated Tuberculosis with Atypical Presentation In An Older Person

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. It is a significant health concern, with millions of new cases and deaths reported each year. Disseminated tuberculosis (dTB) is a serious condition which can affect various organs and tissues, leading to widespread symptoms and complications. The diagnosis of dTB can be challenging due to its atypical presentations. We present a case of dTB in a robust older person who presented with musculoskeletal pain, weight loss, and loss of appetite. Initially, he was treated for age-related spine disease, and pain management was provided. However, his subsequent visit raised suspicion of TB, prompting further work up. The diagnosis was revised to dTB, and anti-TB treatment was initiated. The near miss or delay in diagnosis and treatment may have played a role in dissemination of disease, increased frailty and reduction of function in this patient. Healthcare workers must maintain a high index of suspicion and remain vigilant for TB as starting early treatment will prevent dissemination in the patient, reduce risk to the public and improve outcomes.