Landouzy septicemia in an immunocompetent adult: a case report of fulminant disseminated tuberculosis

Disseminated tuberculosis is characterized by the involvement of two or more non-contiguous sites due to the hematogenous spread of Mycobacterium tuberculosis. This condition can result from a progressive primary infection or the reactivation of a latent focus with subsequent dissemination. A rare and acute form of disseminated tuberculosis, known as Landouzy septicemia, is marked by a sudden onset of septic shock, multi-organ failure, and disseminated intravascular coagulation. This condition, also known as sepsis tuberculosa acutissima, can present significant diagnostic challenges in immunocompromised individuals. We report a case of Landouzy septicemia in an immunocompetent 62-year-old male, who presented with fatigue, fever, bilateral leg swelling, and symptoms indicative of multi-organ involvement. The diagnosis of Landouzy septicemia was confirmed via the GeneXpert MTB assay and a positive Mycobacterium tuberculosis blood culture. Despite aggressive medical intervention following a diagnosis of Landouzy septicemia, the patient succumbed to the condition. This case highlights the diagnostic and therapeutic challenges of Landouzy septicemia, even in immunocompetent individuals, and underscores the importance of early TB recognition in atypical sepsis presentations.