Pulmonary infiltration associated with persistent fever: innefficacy of antibiotic treatment

18-year-old patient suddenly fell ill with fever and symptoms of left lobar pneumonia. He was treated with a 5-day course of antibiotics in his home and then with several different antibiotics in 
two hospitals. After three weeks, he was discharged home. There his temperature 
rose again; he developed cough and lost weight. Six weeks after the onset of the disease, sputum 
cultures showed growth of Myobacterum tuberculosis. The patient was admitted to another hospital
 where he was started on antituberculosis therapy. After one week of treatment, he became afebrile
 and his general condition improved. This case report shows that today, because of lessening 
awareness of pulmonary tuberculosis, the disease can be easily overlooked. Pulmonary tubercuIosis should always be considered in patients with lung infiltrations associated with persistent fever, emaciation, perspiration and cough, resistant to antibiotic therapy. Prior to the institution of etiologic 
treatment the patient had been treated with nine different antibiotics, either with single agents or
 with a combination of several drugs. Although on first admission the patient was suspected of having 
tuberculosis, antituberculosis treatment was not instituted at the time. Of interest is the fact that 
initial and clinical and radiological manifestations of the disease suggested nonspecific lobar pneumonia.