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CASE REPORT
Pulmonary tuberculosis presenting as post-operative fever of unknown origin
  1. Patrick Bogue1,2,
  2. Mhairi Bolland2,
  3. Peter How2,
  4. Harrison Benziger2
  1. 1Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi
  2. 2Department of General Surgery, East Kent Hospitals University NHS Foundation Trust, Margate, UK
  1. Correspondence to Dr Patrick Bogue, patrick.bogue{at}nhs.net

Summary

Post-operative fever is common following emergency surgery. Investigation and management of post-operative fever can be challenging when a clear source of sepsis is not evident or the underlying source of infection is not recognised. We herein report a case of secondary pulmonary tuberculosis presenting as post-operative fever following emergency laparotomy for a perforated duodenal ulcer. This case of tuberculosis was diagnosed on day 41 post-operatively and prior inconclusive results meant that we relied mainly on re-visiting history and examination in order to identify 3 targeted investigations: plain chest X-ray, sputum sample and blood test. Accordingly, the co-management of this complex patient achieved a good outcome.

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Footnotes

  • Twitter Follow Patrick Bogue @padbogue

  • Contributors All authors made substantial contributions to the case report as the clinical team with primary responsibility for this patient. All authors were involved in drafting the work and revising it critically, providing final approval for publication. We agree to be accountable for all aspects of the work.

  • Competing interests None declared.

  • Patient consent Obtained.

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