Metagenomic Next-Generation Sequencing for Diagnosing Challenging Disseminated Tuberculosis: A Case Report

Abstract

Disseminated tuberculosis (TB) is a severe form of TB associated with high mortality typically occurring in individuals with impaired host defenses. It results from the lymphohematogenous dissemination of Mycobacterium tuberculosis from the primary infection site. Diagnosis can be particularly challenging when pulmonary symptoms are absent. We present a case of disseminated TB in a 73-year-old woman who presented with nausea, poor appetite, and low-grade fever. Imaging studies revealed multiple lesions in the lungs, sacroiliac joints, and brain. The nonspecific nature of her initial symptoms, which were inconsistent with the extent of disease involvement, posed significant diagnostic challenges. In this case, metagenomic next-generation sequencing played a pivotal role in confirming the diagnosis of disseminated TB.