Miliary tuberculosis with empyema, a case report

We report a 39 year-old patient who presented with chest pain, malaise, lassitude, anorexia, weight loss, fever, chills, productive coughs, pleural pain in the left thorax area and septic empyema without hemoptysis. Laboratory investigations' including tuberculosis (TB) skin test by PPD, HIV, HBV and HCV serologic tests were negative. The CBC showed anemia and leucocytosis. The ESR was elevated and he had hypoalbuminaemia. Both chest radiograph and high-resolution CT scan showed miliary infiltrates and diffused reticulonodular lung lesions. He was diagnosed with miliary tuberculosis (MTB) via direct staining, PCR and culture from open window region washing sample but not from broncoalveolar lavage. He was treated with antituberculosis drugs.