An Unusual Case of Multidrug Resistant Miliary Tuberculosis

Miliary Tuberculosis (TB) is a rare and lethal form of TB and needs urgent detection and treatment. Miliary TB due to drug-resistant strains of Mycobacterium tuberculosis is even more difficult to manage. We present clinical and bacteriologic findings of a rare case of miliary multi-drug resistant tuberculosis (MDR-TB). Our case was a young female patient with in vitro fertilization (IVF) pregnancy, who had radiological diagnosis of miliary TB and had not responded to antituberculous therapy with four drugs. Second line antituberculous drugs were started empirically and definite diagnosis of MDR-TB was obtained by culture and drug susceptibility test of biopsy specimens. Although very rare, MDR miliary TB can be seen in immunocompetent subjects. We, thereby, emphasize that early recognition and initiation of treatment are associated with a significant improvement in outcomes. Tuberculosis remains a serious worldwide health problem associated with high morbidity and mortality.