Multidrug resistant miliary tuberculosis and Pott's disease in an immunocompetent patient.

In a high tuberculosis TB prevalence country, mortality due to miliary TB is not unknown but the treatment outcome in general is good. We describe a previously healthy man with miliary TB who did not respond to 2-months antituberculous therapy with 4 drugs. Persistent complaints of backache, which antedated chest symptoms, resulted in a diagnosis of Pott's disease. Culture of bronchial aspirate yielded multidrug resistant Mycobacterium tuberculosis that responded slowly to streptomycin, ethionamide, cycloserine, clofazimine, ofloxacin, paraaminosalicylic acid and isoniazid. The association of multidrug resistant miliary TB with Pott's disease in an immunocompetent patient is yet to be highlighted.