case of acute respiratory failure

Pulmonary tuberculosis presenting as respiratory failure requiring mechanical ventilation is not very common. Since Miliary Tuberculosis [MT] without specific treatment is fatal, early diagnosis is critical, and it should be considered in the differential diagnosis of community acquired pneumonias. We present a case of respiratory failure presented as Acute Respiratory Distress Syndrome [ARDS] which failed to respond to nonspecific antibiotics and ventilator strategies, but promptly improved after initiation of Anti Tubercular Regimen [ATT]