Non-Specific Interstitial Pneumonia Overlapping Tuberculosis: A Diagnostic Challenge in Elderly

Non-Specific Interstitial Pneumonia (NSIP) is linked to numerous etiologies, including connective tissue diseases, certain drugs, HIV and idiopathic causes. We present a case of an 82-year-old woman with subacute onset shortness of breath as the presenting feature of Non-specific interstitial pneumonia. Chest imaging demonstrated bilateral infiltrates and tentatively diagnosed as NSIP and started on Tyrosine kinase inhibitor - Nintedanib. But she worsened symptomatically and on further evaluation, Mycobacterium tuberculosis had been detected in her Sputum. Anti-tuberculous therapy and Tyrosine Kinase Inhibitor (TKI) resolved her pulmonary symptoms to an extent and she was discharged on Long term oxygen therapy. In this case, we encountered a Tuberculosis (TB) case with NSIP where NSIP could overlap the diagnosis of TB and we should have a strong suspicion of TB in geriatric people.