DISSEMINATED TUBERCULOSIS IN PLHIV PRESENTED AS PYREXIA OF UNKNOWN ORIGIN: A DIAGNOSTIC REVELATION

Dr. S. Santosh Kannan*, Dr. Rajshree Ramasethu** and Dr. Madhu***

ABSTRACT

A patient presenting with a prolonged fever of unknown origin (PUO) with no identifiable source was diagnosed with disseminated tuberculosis (TB) through Fine Needle Aspiration Cytology (FNAC) of an axillary lymph node. The clinical presentation was atypical, and the diagnosis was challenging due to the absence of other obvious signs of TB or HIV co- infection. FNAC of the lymph node revealed granulomatous inflammation consistent with tuberculosis, prompting the initiation of anti-tuberculosis therapy (ATT). Following the commencement of ATT, the patient showed significant clinical improvement, with resolution of the fever and overall betterment of health. This case highlights the importance of considering TB in the differential diagnosis of PUO, even in the absence of classic symptoms. FNAC of lymph nodes proves to be an effective and minimally invasive diagnostic tool, allowing for early diagnosis and prompt treatment initiation, which led to a positive outcome in this patient.

Keywords: Fever of Unknown Origin, Tuberculosis, Fine Needle Aspiration Cytology, Axillary Lymph Node, Granulomatous Inflammation, Anti-Tuberculosis Therapy, Diagnosis.