Table 2. Chronology of events.
TB: tuberculous, NECT: non-enhanced computed tomography; AFB: acid-fast bacilli, HPE: histopathological examination
| Time | Event / Symptom | Investigation / Treatment |
| -6 months | Right hand pain, intermittent fever, anorexia, weight loss | Self-purchase analgesia |
| -2 months | Difficulty in chewing and swallowing | |
| Day 0 | Presented to Rheumatology Clinic | |
| Day 1 | Admitted to ward to work up for palatal mass | Supportive treatment – hydration, oxygen therapy, analgesia |
| Day 2 | Biopsy of palatal mass | |
| Day 4 | Left exotropia, Fever | NECT brain: left eye staphyloma, no focal brain lesion. Broad-spectrum antibiotics started |
| Day 5 | Nasogastric lavage taken | |
| Day 6 | Desaturated | Non-invasive ventilation. Nasogastric lavage: positive for AFB, HPE of palatal mass confirmed TB. Anti-TB initiated |
| Day 7 | Further deterioration, required inotropic support | Invasive mechanical ventilation, admitted to ICU, started on IV hydrocortisone (sepsis) |
| Day 8 – 11 | Oliguric kidney failure | Renal replacement therapy (acute hemodialysis) |
| Day 12 | Pancytopenia and transaminitis | Blood Culture & Sensitivity throughout admission: No growth |
| Day 13 | Succumbed to illness | |
| 2 months | TB Culture & Sensitivity of nasogastric lavage and endotracheal aspirate: Mycobacterium tuberculosis pan-susceptible to first-line anti-tuberculous agents |