Miliary tuberculosis presenting as acute respiratory distress syndrome, septic shock, DIC, and multiorgan failure.

A 48-year-old Hispanic man developed acute respiratory distress syndrome (ARDS), disseminated intravascular coagulopathy (DIC), fulminant hepatic failure, renal dysfunction, pancytopenia and septic shock, and died on his fourth day of hospitalization. The postmortem examination revealed caseating and non-caseating granulomas in all sampled organs. Antemortem sputum and postmortem pulmonary tissue cultures were positive for Mycobacterium tuberculosis. Miliary tuberculosis (TB) was diagnosed. Factors associated with mortality include delayed diagnosis/therapy and presence of ARDS, DIC, septic shock, and multiorgan failure.