Delayed Symptoms of Miliary Tuberculosis in a Patient with Acute Respiratory Distress Syndrome after Orthopedic Surgery

Abstract

Acute respiratory distress syndrome (ARDS) developed in association with miliary tuberculosis (TB) in a 90-year-old Japanese patient after she underwent orthopedic surgery. Miliary TB is difficult to diagnose, and co-existence of miliary TB and ARDS is uncommon. Pulmonary TB presenting as a postoperative fever of unknown origin has been reported before, but here we report for the first time miliary TB that developed after surgery. A patient’s postoperative condition may mask the diagnosis, potentially leading to premature conclusions. If a patient develops ARDS with unclear etiology, even in hospital, we recommend consideration of the possibility of miliary TB.