Figure 1: Patient’s Brain Magnetic Resonance Image.
To rule out endocarditis, echocardiography was done which detected severe pericardial effusion of about 750 CCs, and pericardiocentesis along with a myocardial biopsy and pericardial smear and culture has been done.
In abdominal and chest spiral CT scans, lesions suspected of miliary TB including adrenal involvement, multiple pulmonary small nodules, and mediastinal lymphadenopathies were seen (Figure 2). In infectious disease consultation sputum smear and culture for mycobacterium tuberculosis, blood and sputum MTB-PCR, cytology MTB-PCR, technetium-99m-ethambutol (Tc-EMB) scintigraphy, and IGRA were sent.