Disseminated Tuberculosis in an Immunocompetent Adult: A Rare Clinical Presentation and Diagnostic Challenge

Disseminated tuberculosis (TB) is a rare and life-threatening form of TB, particularly when it occurs in immunocompetent individuals. A 52-year-old diabetic male presented with tachypnea, tachycardia, and chronic low back pain. Comprehensive imaging revealed pulmonary involvement, lumbosacral vertebral destruction (L5-S1), genitourinary TB, hepatitis, and psoas abscesses. Ultrasound-guided drainage and CB-NAAT analysis confirmed Mycobacterium tuberculosis. Given the patient's deranged liver function tests, a modified antitubercular therapy regimen, including levofloxacin, amikacin, and ethambutol, was administered. The patient demonstrated significant clinical improvement, with resolution of symptoms and normalization of liver function on follow-up. This case underscores the diagnostic complexity of disseminated TB in immunocompetent patients, highlighting the importance of early detection and individualized treatment. Further research is needed to develop standardized treatment protocols, particularly for cases involving multi-organ involvement and liver dysfunction.