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Disseminated tuberculosis involving the eye, skin, axillary lymph nodes and lungs in an immunocompetent host
  1. Obaid Imtiyazul Haque1,
  2. Syed Asghar Rizvi2 and
  3. Ziya Siddiqui2
  1. 1Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Jawaharlal Nehru Medical College and Hospital, Aligarh, Uttar Pradesh, India
  1. Correspondence to Dr Obaid Imtiyazul Haque; oihaque{at}


A female in her early 40s presented to the outpatient clinic for weight loss, fatigue, cough, followed by a gradual painful loss of vision in the right eye associated with redness over the past 3 months. Physical examination revealed bilateral axillary lymphadenopathy and non-healing skin ulcers on the left forearm and the left gluteal region. The patient had no light perception in the right eye and grade 4+ cells in the anterior chamber. A chest X-ray showed a cavitary lesion in the left upper lobe. Histopathological tests from the skin and lymph nodes revealed caseating granulomas, raising the suspicion of tuberculosis. A sputum nucleic acid amplification test was performed, which returned positive for Mycobacterium tuberculosis. The patient was treated with antitubercular chemotherapy and showed encouraging signs of progress after the treatment.

  • TB and other respiratory infections
  • Ophthalmology
  • Dermatology

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  • Contributors OIH, SAR and ZS were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content. OIH, SAR and ZS gave final approval of the manuscript. Is the patient one of the authors of this manuscript? No.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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