Pancytopenia with hypocellular bone marrow due to miliary tuberculosis: an unusual presentation

Abstract

In a patient who presented with fever, weight loss and abdominal swelling, blood counts revealed pancytopenia. Broad-spectrum empirical antibiotic treatment was started because of neutropenic fever, but without effect. The bone marrow was hypocellular with an increase in fat droplets. Peritoneoscopy was performed to evaluate ascites; in the liver biopsy specimen caseous granulomas were seen and the patient was found to suffer from miliary tuberculosis. Antituberculous therapy was begun and the patient recovered completely and the haematological parameters returned to normal.