Disseminated tuberculosis with symptoms of decreased consciousness: A rare case in Indonesian male

BACKGROUNDDisseminated tuberculosis is a rare case that causes high mortality and morbidity. CASE PRESENTATIONA 59-year-old man with a glasgow coma scale of 12, cerebrospinal fluid was found to have dominant mononuclear, high protein level, low glucose level and shortness of breath. A chest X-ray revealed a right pleural effusion with infiltrates in both lung parenchyma and a pleural fluid adenosine deaminase (ADA) test showed 66.1 U/L. Thoracolumbar MRI revealed a compression fracture in the 6th thoracic vertebral body. The patient was given category 1 anti-tuberculosis drug (ATD) therapy plus streptomycin and dexamethasone and water seal drainage (WSD) was installed. The patient experienced improvement after taking ATD after 4 months in which the patient could stand and walk by using an object in front of him. DISCUSSIONAccurate and prompt diagnosis of disseminated tuberculosis minimizes patient's mortality and morbidity. Suspicion of tuberculosis can be raised if the patient is experiencing health problems in endemic tuberculosis. CONCLUSIONDisseminated tuberculosis (pulmonary tuberculosis, tuberculous pleurisy, tuberculous meningitis, and tuberculous spondylitis) can be managed properly using ATD category 1.