Cryptic tuberculosis: a missed diagnosis and an unusual presentation

Abstract

Cryptic tuberculosis is a rare and atypical clinical presentation of disseminated hematogenously spread tuberculosis, in which the usual diagnostic criteria for tuberculosis, especially the roentgenographic evidence, are lacking. Here we report a case of an elderly female with prolonged respiratory distress, persistent anaemia, with thrombocytopenia and hypoproteinaemia; inspite of long term treatment and normal X-ray chest. Diagnosis of cryptic tuberculosis was established only after histopathology report of a late appearing axillary lymph node during the course of treatment. The incidence of these occult forms of tuberculosis, where diagnosis is often established too late or entirely missed, is significant. This possibility must be kept in mind in severe infectious conditions and pyrexia of unknown origin without obvious aetiology.