Tuberculosis miliar en una paciente joven inmunocompetente con GeneXpert negativo: reporte de caso

Miliary tuberculosis is a severe form of haematogenous dissemination of Mycobacterium tuberculosis, difficult to diagnose because of its non-specific presentation and paucibacillary nature. The study therefore aimed to describe the case of a young immunocompetent patient with miliary tuberculosis and a negative molecular test, and to highlight the relevance of clinical and radiological correlation in endemic settings. A case report based on the clinical record was used, involving a 24-year-old woman from a rural area with an eight-month constitutional syndrome, night fever, 13.8% weight loss and cough unresponsive to antibiotics. A bilateral diffuse micronodular pattern, two negative GeneXpert MTB/RIF Ultra tests and non-reactive HIV were found, with improvement after antituberculosis treatment. It was concluded that a negative molecular test does not rule out the disease.