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Miliary tuberculosis is quite a rare but serious cause of acute respiratory distress syndrome (ARDS). Therefore, the early detection of military tuberculosis as the underlying cause of ARDS is very important for the prognosis and survival of the patient. We report a case of military tuberculosis mimicking ARDS. A female patient was admitted due to repeated fever and dyspnea. The initial chest CT scan showed diffuse ground glass opacity, without a miliary pattern. The case was considered to be ARDS caused by pneumonia. She showed improvement after being treated with levofloxacin. However, she was re-admitted with fever seven days after discharge. The follow up chest CT scan showed micronodules in both lungs. An open lung biopsy confirmed the diagnosis of military tuberculosis.

A Case of Miliary Tuberculosis Misdiagnosed as Pneumonia and ARDS Due to the Transient Improvement after Intravenous Injection of Levofloxacin