Disseminated tubercle bacilli to distant sites including liver, spleen, skin. Organomegaly , tubercular pneumonia, lymphadenitis, papulonecrotic tuberculids or purpura appearing on the skin. Bone marrow involvement with leukoerythroblastic picture is seen. AFB staining of bone marrow, PPD test, culture of sputum/ bronchial aspirate for tubercular bacilli will help. 45 days history also goes in favor of tuberculosis. Lymph node biopsy and liver biopsy will also help in diagnosis. CNS involvement is also should be ruled out in such cases.
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