• Huan Li, Fang He, Cejun Zhong, and Junyan Qu.
• Center of Infectious Disease, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, China.
• Medicine (Baltimore). 2022 Feb 18; 101 (7): e28656e28656.

RationaleThe clinical manifestations in patients with disseminated tuberculosis (TB) are nonspecific and may present challenges for early diagnosis.Patient Concerns And DiagnosesWe describe the case of a 44-year-old man who presented with abdominal pain and discomfort for more than a month. He had undergone surgery for a chest wall abscess 9 months ago. Computed tomography scans showed a miliary pattern in the lung and multiple abscesses in the liver, spleen, left psoas major muscle, skin, and soft tissue, with rim enhancement. Mycobacterium tuberculosis was detected in the drainage fluid of the abscesses and surgical slices, and disseminated TB was diagnosed.Interventions And OutcomesWith anti-tuberculosis therapy, the abscesses were gradually absorbed and all cultures were negative.LessonsThe patient exemplifies the difficulty of the early diagnosis of disseminated TB. Disseminated TB should be considered first in patients with multisystem illness, and then evidence should be pursued relentlessly to establish a diagnosis.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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