BMJ Case Reports 2018; doi:10.1136/bcr-2018-224166
  • Global health

Empirical treatment of tuberculosis: TB or not TB?

  1. Rakesh Biswas2
  1. 1Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
  2. 2Medicine, Kamineni Institute of Medical Sciences, Narketpally, Telangana, India
  1. Correspondence to Professor Rakesh Biswas, rakesh7biswas{at}
  • Accepted 16 June 2018
  • Published 10 July 2018


Of the 8.6 million new cases of tuberculosis (TB) that occur globally each year, a quarter occur in India. We describe the case of a 38-year-old Indian woman who presented with symptoms of hepatitis after being treated empirically with anti-TB therapy for five months. The patient was suspected to have TB after having recurrent episodes of coughing which would improve briefly before her respiratory symptoms returned, which led to her being treated at various healthcare clinics and hospitals. We highlight the challenges the patient faced due to the lack of centralised medical records which would have prevented unnecessary investigations and treatment.


  • Contributors EW and NKV contributed equally to this paper in terms of collecting information, conducting background research, drafting and producing a finalised version of this paper. RB was integral in raising aspects of the patient’s care to be investigated further and provided feedback during the draft stages to create the final report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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