Significance of surgical intervention in diagnosing disseminated miliary tuberculosis complicated by small bowel perforation

Tuberculosis (TB) is an infectious disease mainly caused by Mycobacterium tuberculosis. TB is an acid-fast staining rod that gets transmitted through aerosolized droplets. Even though TB cases in the United States are decreasing, it is still prevalent in the developing world, especially in travelers from countries with endemic TB. TB is primarily a lung infection because of its aerosol transmission. It can become a systemic infection and last in the body for long periods of time. When the infection becomes systemic, it gets labeled as miliary TB because of the lymphohematogenous and disseminated spread. In this case report, we present an exceedingly rare case of a young patient with latent miliary TB who presents to the hospital with gastrointestinal complaints, ultimately having a small bowel perforation and a complicated hospital course which followed. Of note, according to the CDC, US cases of TB are about 2.7% per 100,000, of which military tuberculosis is a rare complication as low as <2% (6). Secondarily, systolic blood pressure can range from as low as 7% up to 30% occurrence based on the etiology, and patient presentation. Combining both factors can elucidate how rare it is for SBP and disseminated TB to occur individually, let alone simultaneously.