ArticleCureus2026
Fine-Needle Aspiration Cytology (FNAC)-Based Diagnosis of Disseminated Tuberculosis in an HIV-Positive Patient Presenting With Pyrexia of Unknown Origin.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Pyrexia of unknown origin (PUO) in immunocompromised patients presents a significant diagnostic challenge, particularly when common clinical clues are absent. In human immunodeficiency virus (HIV)-positive individuals, tuberculosis (TB) often manifests atypically, leading to diagnostic delays and potentially worsening outcomes. We report the case of a middle-aged HIV-positive man who presented with persistent high-grade fever without an identifiable source. Despite comprehensive investigations, routine diagnostic tests yielded inconclusive results. Fine-needle aspiration cytology (FNAC) of an axillary lymph node revealed necrotizing granulomatous inflammation consistent with tuberculosis. The initiation of anti-tuberculosis therapy (ATT) led to rapid clinical improvement. This case highlights the importance of considering disseminated TB in the differential diagnosis of PUO in HIV-infected patients, even in the absence of classical pulmonary or systemic signs. FNAC proved to be a pivotal diagnostic tool in identifying the etiology and guiding effective treatment. Early recognition and timely intervention can markedly improve outcomes in such complex presentations.
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